How much rates vary
Facilitymedian $2,818 · 10th to 90th $229 to $9,550Professionalmedian $240 · 10th to 90th $178 to $363
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 $213.80 Median $3,981.07 Typical High $9,332.54 | Facility | None | $213.80 | $3,981.07 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $213.80 Typical High $371.54 | Professional | None | $158.49 | $213.80 | $371.54 |
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 $186.21 Median $245.47 Typical High $331.13 | Professional | None | $186.21 | $245.47 | $331.13 |
CareFirst Setting Professional Modifier None Typical Low $181.97 Median $204.17 Typical High $2,818.38 | Professional | None | $181.97 | $204.17 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $1,659.59 Typical High $3,311.31 | Facility | None | $346.74 | $1,659.59 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $239.88 Typical High $371.54 | Professional | None | $181.97 | $239.88 | $371.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $162.18 Median $281.84 Typical High $346.74 | Professional | None | $162.18 | $281.84 | $346.74 |
Medcost Setting Professional Modifier None Typical Low $263.03 Median $323.59 Typical High $323.59 | Professional | None | $263.03 | $323.59 | $323.59 |
Medcost Setting Facility Modifier None Typical Low $199.53 Median $229.09 Typical High $380.19 | Facility | None | $199.53 | $229.09 | $380.19 |
Medcost Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
Sentara Setting Facility Modifier None Typical Low $165.96 Median $933.25 Typical High $8,709.64 | Facility | None | $165.96 | $933.25 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $208.93 Median $281.84 Typical High $4,073.80 | Professional | None | $208.93 | $281.84 | $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 $151.36 Median $251.19 Typical High $398.11 | Professional | None | $151.36 | $251.19 | $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 $79.43 Median $104.71 Typical High $114.82 | Professional | 52 · Reduced service | $79.43 | $104.71 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $41.69 Typical High $45.71 | Professional | 53 · Discontinued | $31.62 | $41.69 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $158.49 Typical High $173.78 | Professional | 54 · Surgery only | $117.49 | $158.49 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $31.62 Typical High $34.67 | Professional | 55 · Aftercare only | $23.44 | $31.62 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $20.89 Typical High $22.91 | Professional | 56 · Pre-op care only | $15.85 | $20.89 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $147.91 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $109.65 | $147.91 | $162.18 |
Where Virginia sits
The same service costs 4.4 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· 41st of 51
$245
AK $871UT $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.