How much rates vary
Facilitymedian $3,467 · 10th to 90th $347 to $9,550Professionalmedian $324 · 10th to 90th $269 to $417
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 $346.74 Median $3,801.89 Typical High $9,332.54 | Facility | None | $346.74 | $3,801.89 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $346.74 Typical High $537.03 | Professional | None | $323.59 | $346.74 | $537.03 |
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 $275.42 Median $331.13 Typical High $389.05 | Professional | None | $275.42 | $331.13 | $389.05 |
CareFirst Setting Professional Modifier None Typical Low $275.42 Median $309.03 Typical High $363.08 | Professional | None | $275.42 | $309.03 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $2,691.53 Typical High $5,754.40 | Facility | None | $524.81 | $2,691.53 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $309.03 Typical High $436.52 | Professional | None | $281.84 | $309.03 | $436.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $251.19 Median $288.40 Typical High $489.78 | Professional | None | $251.19 | $288.40 | $489.78 |
Medcost Setting Professional Modifier None Typical Low $371.54 Median $467.74 Typical High $467.74 | Professional | None | $371.54 | $467.74 | $467.74 |
Medcost Setting Facility Modifier None Typical Low $323.59 Median $389.05 Typical High $524.81 | Facility | None | $323.59 | $389.05 | $524.81 |
Medcost Setting Professional Modifier None Typical Low $346.74 Median $371.54 Typical High $537.03 | Professional | None | $346.74 | $371.54 | $537.03 |
Sentara Setting Facility Modifier None Typical Low $269.15 Median $1,288.25 Typical High $8,709.64 | Facility | None | $269.15 | $1,288.25 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $295.12 Median $338.84 Typical High $489.78 | Professional | None | $295.12 | $338.84 | $489.78 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $5,011.87 Typical High $13,182.57 | Facility | None | $1,258.93 | $5,011.87 | $13,182.57 |
United Setting Professional Modifier None Typical Low $223.87 Median $275.42 Typical High $489.78 | Professional | None | $223.87 | $275.42 | $489.78 |
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 $162.18 Median $162.18 Typical High $173.78 | Professional | 52 · Reduced service | $162.18 | $162.18 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $64.57 Typical High $69.18 | Professional | 53 · Discontinued | $64.57 | $64.57 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $245.47 Typical High $257.04 | Professional | 54 · Surgery only | $245.47 | $245.47 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $51.29 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $34.67 | Professional | 56 · Pre-op care only | $32.36 | $32.36 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $229.09 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $229.09 | $229.09 | $239.88 |
Where Virginia sits
The same service costs 5.5 times more in Alaska than in Utah. 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· 37th of 51
$324
AK $1,202UT $219
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.