How much rates vary
Facilitymedian $3,236 · 10th to 90th $468 to $9,550Professionalmedian $447 · 10th to 90th $372 to $724
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 $446.68 Median $4,786.30 Typical High $10,000.00 | Facility | None | $446.68 | $4,786.30 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $446.68 Typical High $3,467.37 | Professional | None | $426.58 | $446.68 | $3,467.37 |
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 $371.54 Median $446.68 Typical High $575.44 | Professional | None | $371.54 | $446.68 | $575.44 |
CareFirst Setting Professional Modifier None Typical Low $389.05 Median $436.52 Typical High $758.58 | Professional | None | $389.05 | $436.52 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,737.80 Typical High $3,235.94 | Facility | None | $478.63 | $1,737.80 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $467.74 Typical High $676.08 | Professional | None | $389.05 | $467.74 | $676.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $354.81 Median $426.58 Typical High $524.81 | Professional | None | $354.81 | $426.58 | $524.81 |
Medcost Setting Professional Modifier None Typical Low $489.78 Median $616.60 Typical High $616.60 | Professional | None | $489.78 | $616.60 | $616.60 |
Medcost Setting Facility Modifier None Typical Low $446.68 Median $588.84 Typical High $724.44 | Facility | None | $446.68 | $588.84 | $724.44 |
Medcost Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
Sentara Setting Facility Modifier None Typical Low $354.81 Median $1,479.11 Typical High $8,709.64 | Facility | None | $354.81 | $1,479.11 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $371.54 Median $537.03 Typical High $4,073.80 | Professional | None | $371.54 | $537.03 | $4,073.80 |
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 $323.59 Median $512.86 Typical High $794.33 | Professional | None | $323.59 | $512.86 | $794.33 |
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 $213.80 Median $223.87 Typical High $223.87 | Professional | 52 · Reduced service | $213.80 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $89.13 Typical High $89.13 | Professional | 53 · Discontinued | $85.11 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $338.84 Typical High $338.84 | Professional | 54 · Surgery only | $316.23 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $67.61 Typical High $67.61 | Professional | 55 · Aftercare only | $64.57 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $42.66 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $316.23 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $302.00 | $316.23 | $316.23 |
Where Virginia sits
The same service costs 6.2 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· 46th of 51
$468
AK $1,862UT $302
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.