How much rates vary
Facilitymedian $3,090 · 10th to 90th $631 to $9,550Professionalmedian $617 · 10th to 90th $513 to $759
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 $676.08 Median $4,786.30 Typical High $10,000.00 | Facility | None | $676.08 | $4,786.30 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $676.08 Typical High $676.08 | Professional | None | $630.96 | $676.08 | $676.08 |
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 $524.81 Median $630.96 Typical High $758.58 | Professional | None | $524.81 | $630.96 | $758.58 |
CareFirst Setting Professional Modifier None Typical Low $575.44 Median $630.96 Typical High $741.31 | Professional | None | $575.44 | $630.96 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,479.11 Typical High $2,691.53 | Facility | None | $478.63 | $1,479.11 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $588.84 Typical High $812.83 | Professional | None | $501.19 | $588.84 | $812.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $549.54 Median $630.96 Typical High $851.14 | Professional | None | $549.54 | $630.96 | $851.14 |
Medcost Setting Professional Modifier None Typical Low $588.84 Median $741.31 Typical High $776.25 | Professional | None | $588.84 | $741.31 | $776.25 |
Medcost Setting Facility Modifier None Typical Low $630.96 Median $645.65 Typical High $1,023.29 | Facility | None | $630.96 | $645.65 | $1,023.29 |
Medcost Setting Professional Modifier None Typical Low $575.44 Median $588.84 Typical High $776.25 | Professional | None | $575.44 | $588.84 | $776.25 |
Sentara Setting Facility Modifier None Typical Low $457.09 Median $1,737.80 Typical High $8,709.64 | Facility | None | $457.09 | $1,737.80 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $457.09 Median $588.84 Typical High $933.25 | Professional | None | $457.09 | $588.84 | $933.25 |
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 $389.05 Median $524.81 Typical High $891.25 | Professional | None | $389.05 | $524.81 | $891.25 |
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 $316.23 Median $316.23 Typical High $338.84 | Professional | 52 · Reduced service | $316.23 | $316.23 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $134.90 | Professional | 53 · Discontinued | $125.89 | $125.89 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $512.86 | Professional | 54 · Surgery only | $467.74 | $467.74 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $102.33 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $67.61 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $478.63 |
Where Virginia sits
The same service costs 5.5 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· 35th of 51
$617
AK $2,344TX $427
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.