How much rates vary
Facilitymedian $759 · 10th to 90th $135 to $4,074Professionalmedian $457 · 10th to 90th $372 to $550
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 $489.78 Median $4,073.80 Typical High $10,000.00 | Facility | None | $489.78 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $467.74 Typical High $489.78 | Professional | None | $457.09 | $467.74 | $489.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $2,398.83 Typical High $2,951.21 | Facility | None | $1,698.24 | $2,398.83 | $2,951.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $380.19 Median $457.09 Typical High $549.54 | Professional | None | $380.19 | $457.09 | $549.54 |
CareFirst Setting Professional Modifier None Typical Low $407.38 Median $457.09 Typical High $524.81 | Professional | None | $407.38 | $457.09 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $134.90 Typical High $251.19 | Facility | None | $50.12 | $134.90 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $436.52 Typical High $602.56 | Professional | None | $380.19 | $436.52 | $602.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $354.81 Median $407.38 Typical High $676.08 | Professional | None | $354.81 | $407.38 | $676.08 |
Medcost Setting Professional Modifier None Typical Low $501.19 Median $616.60 Typical High $616.60 | Professional | None | $501.19 | $616.60 | $616.60 |
Medcost Setting Facility Modifier None Typical Low $457.09 Median $512.86 Typical High $758.58 | Facility | None | $457.09 | $512.86 | $758.58 |
Medcost Setting Professional Modifier None Typical Low $263.03 Median $354.81 Typical High $501.19 | Professional | None | $263.03 | $354.81 | $501.19 |
Sentara Setting Facility Modifier None Typical Low $316.23 Median $537.03 Typical High $2,454.71 | Facility | None | $316.23 | $537.03 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $363.08 Median $457.09 Typical High $691.83 | Professional | None | $363.08 | $457.09 | $691.83 |
United Setting Facility Modifier None Typical Low $100.00 Median $660.69 Typical High $2,041.74 | Facility | None | $100.00 | $660.69 | $2,041.74 |
United Setting Professional Modifier None Typical Low $302.00 Median $389.05 Typical High $676.08 | Professional | None | $302.00 | $389.05 | $676.08 |
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 $229.09 Median $229.09 Typical High $245.47 | Professional | 52 · Reduced service | $229.09 | $229.09 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $97.72 | Professional | 53 · Discontinued | $93.33 | $93.33 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $346.74 Typical High $363.08 | Professional | 54 · Surgery only | $346.74 | $346.74 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $72.44 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $48.98 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $323.59 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $323.59 | $323.59 | $338.84 |
Where Virginia sits
The same service costs 4.2 times more in Wyoming 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· 33rd of 51
$457
WY $1,288UT $309
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.