How much rates vary
Facilitymedian $1,950 · 10th to 90th $316 to $9,120Professionalmedian $339 · 10th to 90th $229 to $617
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 $316.23 Median $676.08 Typical High $7,244.36 | Facility | None | $316.23 | $676.08 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $398.11 Typical High $758.58 | Professional | None | $257.04 | $398.11 | $758.58 |
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 $229.09 Median $316.23 Typical High $446.68 | Professional | None | $229.09 | $316.23 | $446.68 |
CareFirst Setting Professional Modifier None Typical Low $229.09 Median $251.19 Typical High $2,511.89 | Professional | None | $229.09 | $251.19 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,122.02 Typical High $2,187.76 | Facility | None | $478.63 | $1,122.02 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $338.84 Typical High $676.08 | Professional | None | $234.42 | $338.84 | $676.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $213.80 Median $407.38 Typical High $501.19 | Professional | None | $213.80 | $407.38 | $501.19 |
Medcost Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $851.14 | Professional | None | $691.83 | $851.14 | $851.14 |
Medcost Setting Facility Modifier None Typical Low $257.04 Median $416.87 Typical High $676.08 | Facility | None | $257.04 | $416.87 | $676.08 |
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 $208.93 Median $1,023.29 Typical High $8,709.64 | Facility | None | $208.93 | $1,023.29 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $371.54 Median $501.19 Typical High $4,073.80 | Professional | None | $371.54 | $501.19 | $4,073.80 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $4,897.79 Typical High $13,182.57 | Facility | None | $1,230.27 | $4,897.79 | $13,182.57 |
United Setting Professional Modifier None Typical Low $204.17 Median $371.54 Typical High $724.44 | Professional | None | $204.17 | $371.54 | $724.44 |
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 $128.82 Median $162.18 Typical High $208.93 | Professional | 52 · Reduced service | $128.82 | $162.18 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $66.07 Typical High $83.18 | Professional | 53 · Discontinued | $51.29 | $66.07 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $245.47 Typical High $316.23 | Professional | 54 · Surgery only | $194.98 | $245.47 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $48.98 Typical High $63.10 | Professional | 55 · Aftercare only | $38.90 | $48.98 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $33.11 Typical High $41.69 | Professional | 56 · Pre-op care only | $25.70 | $33.11 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $229.09 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $181.97 | $229.09 | $295.12 |
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· 44th of 51
$363
AK $1,259UT $275
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.