How much rates vary
Facilitymedian $2,455 · 10th to 90th $234 to $9,333Professionalmedian $229 · 10th to 90th $182 to $339
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 $229.09 Median $380.19 Typical High $8,317.64 | Facility | None | $229.09 | $380.19 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $229.09 Typical High $380.19 | Professional | None | $199.53 | $229.09 | $380.19 |
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 $177.83 Median $218.78 Typical High $288.40 | Professional | None | $177.83 | $218.78 | $288.40 |
CareFirst Setting Professional Modifier None Typical Low $181.97 Median $199.53 Typical High $3,548.13 | Professional | None | $181.97 | $199.53 | $3,548.13 |
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 $181.97 Median $234.42 Typical High $346.74 | Professional | None | $181.97 | $234.42 | $346.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $165.96 Median $257.04 Typical High $316.23 | Professional | None | $165.96 | $257.04 | $316.23 |
Medcost Setting Professional Modifier None Typical Low $281.84 Median $354.81 Typical High $354.81 | Professional | None | $281.84 | $354.81 | $354.81 |
Medcost Setting Facility Modifier None Typical Low $208.93 Median $269.15 Typical High $380.19 | Facility | None | $208.93 | $269.15 | $380.19 |
Medcost Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
Sentara Setting Facility Modifier None Typical Low $177.83 Median $933.25 Typical High $8,709.64 | Facility | None | $177.83 | $933.25 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $208.93 Median $281.84 Typical High $4,570.88 | Professional | None | $208.93 | $281.84 | $4,570.88 |
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 $162.18 Median $263.03 Typical High $398.11 | Professional | None | $162.18 | $263.03 | $398.11 |
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 $100.00 Median $107.15 Typical High $117.49 | Professional | 52 · Reduced service | $100.00 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $42.66 Typical High $46.77 | Professional | 53 · Discontinued | $39.81 | $42.66 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $158.49 Typical High $177.83 | Professional | 54 · Surgery only | $147.91 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $31.62 Typical High $35.48 | Professional | 55 · Aftercare only | $29.51 | $31.62 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $21.38 Typical High $23.44 | Professional | 56 · Pre-op care only | $19.95 | $21.38 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $147.91 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $138.04 | $147.91 | $165.96 |
Where Virginia sits
The same service costs 5.9 times more in Oklahoma 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· 44th of 51
$234
OK $1,175UT $200
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.