How much rates vary
Facilitymedian $3,162 · 10th to 90th $355 to $10,965Professionalmedian $251 · 10th to 90th $200 to $427
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 $251.19 Median $3,801.89 Typical High $9,332.54 | Facility | None | $251.19 | $3,801.89 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $380.19 | Professional | None | $251.19 | $251.19 | $380.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $6,456.54 Typical High $7,244.36 | Facility | None | $4,677.35 | $6,456.54 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $245.47 Typical High $288.40 | Professional | None | $204.17 | $245.47 | $288.40 |
CareFirst Setting Professional Modifier None Typical Low $199.53 Median $223.87 Typical High $263.03 | Professional | None | $199.53 | $223.87 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $1,621.81 Typical High $3,090.30 | Facility | None | $346.74 | $1,621.81 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $229.09 Typical High $489.78 | Professional | None | $208.93 | $229.09 | $489.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $190.55 Median $218.78 Typical High $380.19 | Professional | None | $190.55 | $218.78 | $380.19 |
Medcost Setting Professional Modifier None Typical Low $512.86 Median $645.65 Typical High $645.65 | Professional | None | $512.86 | $645.65 | $645.65 |
Medcost Setting Facility Modifier None Typical Low $251.19 Median $407.38 Typical High $501.19 | Facility | None | $251.19 | $407.38 | $501.19 |
Medcost Setting Professional Modifier None Typical Low $416.87 Median $489.78 Typical High $537.03 | Professional | None | $416.87 | $489.78 | $537.03 |
Sentara Setting Facility Modifier None Typical Low $239.88 Median $1,023.29 Typical High $10,232.93 | Facility | None | $239.88 | $1,023.29 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $229.09 Median $398.11 Typical High $512.86 | Professional | None | $229.09 | $398.11 | $512.86 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $6,760.83 Typical High $16,595.87 | Facility | None | $1,548.82 | $6,760.83 | $16,595.87 |
United Setting Professional Modifier None Typical Low $181.97 Median $288.40 Typical High $537.03 | Professional | None | $181.97 | $288.40 | $537.03 |
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 $125.89 Median $125.89 Typical High $125.89 | Professional | 52 · Reduced service | $125.89 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $50.12 Typical High $51.29 | Professional | 53 · Discontinued | $50.12 | $50.12 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | 54 · Surgery only | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | 55 · Aftercare only | $38.02 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | 56 · Pre-op care only | $25.12 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $177.83 | $177.83 | $177.83 |
Where Virginia sits
The same service costs 4.6 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· 45th of 51
$251
AK $891UT $195
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.