How much rates vary
Facilitymedian $4,074 · 10th to 90th $550 to $13,490Professionalmedian $1,230 · 10th to 90th $380 to $2,570
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 $426.58 Median $4,365.16 Typical High $10,000.00 | Facility | None | $426.58 | $4,365.16 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $1,548.82 Typical High $1,819.70 | Professional | None | $407.38 | $1,548.82 | $1,819.70 |
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 $380.19 Median $1,023.29 Typical High $1,778.28 | Professional | None | $380.19 | $1,023.29 | $1,778.28 |
CareFirst Setting Professional Modifier None Typical Low $380.19 Median $416.87 Typical High $4,786.30 | Professional | None | $380.19 | $416.87 | $4,786.30 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,318.26 Typical High $2,691.53 | Facility | None | $512.86 | $1,318.26 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $1,096.48 Typical High $3,467.37 | Professional | None | $389.05 | $1,096.48 | $3,467.37 |
Kaiser Permanente Setting Professional Modifier None Typical Low $346.74 Median $1,659.59 Typical High $2,041.74 | Professional | None | $346.74 | $1,659.59 | $2,041.74 |
Medcost Setting Professional Modifier None Typical Low $4,365.16 Median $5,495.41 Typical High $5,495.41 | Professional | None | $4,365.16 | $5,495.41 | $5,495.41 |
Medcost Setting Facility Modifier None Typical Low $426.58 Median $912.01 Typical High $3,467.37 | Facility | None | $426.58 | $912.01 | $3,467.37 |
Medcost Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | None | $3,019.95 | $3,019.95 | $3,019.95 |
Sentara Setting Facility Modifier None Typical Low $426.58 Median $1,737.80 Typical High $10,232.93 | Facility | None | $426.58 | $1,737.80 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1,479.11 Median $2,238.72 Typical High $7,762.47 | Professional | None | $1,479.11 | $2,238.72 | $7,762.47 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $8,511.38 Typical High $20,417.38 | Facility | None | $1,995.26 | $8,511.38 | $20,417.38 |
United Setting Professional Modifier None Typical Low $354.81 Median $1,096.48 Typical High $3,388.44 | Professional | None | $354.81 | $1,096.48 | $3,388.44 |
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 $204.17 Median $512.86 Typical High $851.14 | Professional | 52 · Reduced service | $204.17 | $512.86 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $204.17 Typical High $346.74 | Professional | 53 · Discontinued | $83.18 | $204.17 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $776.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $309.03 | $776.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $154.88 Typical High $257.04 | Professional | 55 · Aftercare only | $61.66 | $154.88 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $102.33 Typical High $173.78 | Professional | 56 · Pre-op care only | $40.74 | $102.33 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $724.44 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $288.40 | $724.44 | $1,202.26 |
Where Virginia sits
The same service costs 4.9 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· 38th of 51
$1,318
AK $3,020TX $617
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.