How much rates vary
Facilitymedian $5,495 · 10th to 90th $933 to $13,490Professionalmedian $891 · 10th to 90th $741 to $1,148
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $977.24 Median $5,623.41 Typical High $10,964.78 | Facility | None | $977.24 | $5,623.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $977.24 | Professional | None | $933.25 | $933.25 | $977.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $7,413.10 Typical High $9,549.93 | Facility | None | $6,165.95 | $7,413.10 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $1,096.48 | Professional | None | $776.25 | $912.01 | $1,096.48 |
CareFirst Setting Professional Modifier None Typical Low $758.58 Median $851.14 Typical High $1,000.00 | Professional | None | $758.58 | $851.14 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $3,019.95 Typical High $5,754.40 | Facility | None | $645.65 | $3,019.95 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $851.14 Typical High $1,230.27 | Professional | None | $794.33 | $851.14 | $1,230.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $691.83 Median $794.33 Typical High $1,380.38 | Professional | None | $691.83 | $794.33 | $1,380.38 |
Medcost Setting Professional Modifier None Typical Low $1,122.02 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,122.02 | $1,412.54 | $1,412.54 |
Medcost Setting Facility Modifier None Typical Low $933.25 Median $1,096.48 Typical High $1,548.82 | Facility | None | $933.25 | $1,096.48 | $1,548.82 |
Medcost Setting Professional Modifier None Typical Low $977.24 Median $1,047.13 Typical High $1,819.70 | Professional | None | $977.24 | $1,047.13 | $1,819.70 |
Sentara Setting Facility Modifier None Typical Low $794.33 Median $2,238.72 Typical High $10,232.93 | Facility | None | $794.33 | $2,238.72 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $851.14 Median $954.99 Typical High $1,412.54 | Professional | None | $851.14 | $954.99 | $1,412.54 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $8,511.38 Typical High $20,417.38 | Facility | None | $1,995.26 | $8,511.38 | $20,417.38 |
United Setting Professional Modifier None Typical Low $645.65 Median $794.33 Typical High $1,412.54 | Professional | None | $645.65 | $794.33 | $1,412.54 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $467.74 Median $467.74 Typical High $489.78 | Professional | 52 · Reduced service | $467.74 | $467.74 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $186.21 Typical High $194.98 | Professional | 53 · Discontinued | $186.21 | $186.21 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $724.44 | Professional | 54 · Surgery only | $707.95 | $707.95 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $144.54 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $93.33 Typical High $97.72 | Professional | 56 · Pre-op care only | $93.33 | $93.33 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $676.08 |
Where Virginia sits
The same service costs 6.5 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Virginia· 36th of 51
$891
AK $3,311TX $513
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.