How much rates vary
Facilitymedian $3,388 · 10th to 90th $269 to $10,233Professionalmedian $302 · 10th to 90th $209 to $468
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 $371.54 Median $7,079.46 Typical High $15,488.17 | Facility | None | $371.54 | $7,079.46 | $15,488.17 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $323.59 Typical High $467.74 | Professional | None | $234.42 | $323.59 | $467.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $3,715.35 Typical High $4,265.80 | Facility | None | $2,884.03 | $3,715.35 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $208.93 Median $316.23 Typical High $457.09 | Professional | None | $208.93 | $316.23 | $457.09 |
CareFirst Setting Professional Modifier None Typical Low $208.93 Median $234.42 Typical High $275.42 | Professional | None | $208.93 | $234.42 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $977.24 Median $1,905.46 Typical High $3,548.13 | Facility | None | $977.24 | $1,905.46 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $323.59 Typical High $426.58 | Professional | None | $213.80 | $323.59 | $426.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $363.08 Median $426.58 Typical High $562.34 | Professional | None | $363.08 | $426.58 | $562.34 |
Medcost Setting Professional Modifier None Typical Low $331.13 Median $416.87 Typical High $416.87 | Professional | None | $331.13 | $416.87 | $416.87 |
Medcost Setting Facility Modifier None Typical Low $234.42 Median $371.54 Typical High $602.56 | Facility | None | $234.42 | $371.54 | $602.56 |
Medcost Setting Professional Modifier None Typical Low $181.97 Median $269.15 Typical High $371.54 | Professional | None | $181.97 | $269.15 | $371.54 |
Sentara Setting Facility Modifier None Typical Low $194.98 Median $954.99 Typical High $9,332.54 | Facility | None | $194.98 | $954.99 | $9,332.54 |
Sentara Setting Professional Modifier None Typical Low $239.88 Median $363.08 Typical High $602.56 | Professional | None | $239.88 | $363.08 | $602.56 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,011.87 Typical High $13,182.57 | Facility | None | $1,230.27 | $5,011.87 | $13,182.57 |
United Setting Professional Modifier None Typical Low $169.82 Median $281.84 Typical High $467.74 | Professional | None | $169.82 | $281.84 | $467.74 |
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 $117.49 Median $147.91 Typical High $234.42 | Professional | 52 · Reduced service | $117.49 | $147.91 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $58.88 Typical High $93.33 | Professional | 53 · Discontinued | $46.77 | $58.88 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $218.78 Typical High $346.74 | Professional | 54 · Surgery only | $173.78 | $218.78 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $43.65 Typical High $69.18 | Professional | 55 · Aftercare only | $34.67 | $43.65 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $29.51 Typical High $46.77 | Professional | 56 · Pre-op care only | $23.44 | $29.51 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $204.17 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $162.18 | $204.17 | $323.59 |
Where Virginia sits
The same service costs 3.7 times more in Wyoming 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
$309
WY $891TX $240
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.