How much rates vary
Facilitymedian $3,467 · 10th to 90th $537 to $9,772Professionalmedian $550 · 10th to 90th $427 to $851
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 $524.81 Median $4,786.30 Typical High $10,000.00 | Facility | None | $524.81 | $4,786.30 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $524.81 Typical High $3,162.28 | Professional | None | $416.87 | $524.81 | $3,162.28 |
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 $467.74 Median $562.34 Typical High $724.44 | Professional | None | $467.74 | $562.34 | $724.44 |
CareFirst Setting Professional Modifier None Typical Low $489.78 Median $549.54 Typical High $831.76 | Professional | None | $489.78 | $549.54 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $2,187.76 Typical High $4,365.16 | Facility | None | $478.63 | $2,187.76 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $512.86 Typical High $812.83 | Professional | None | $446.68 | $512.86 | $812.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $489.78 Typical High $616.60 | Professional | None | $416.87 | $489.78 | $616.60 |
Medcost Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $707.95 | Professional | None | $562.34 | $707.95 | $707.95 |
Medcost Setting Facility Modifier None Typical Low $524.81 Median $616.60 Typical High $851.14 | Facility | None | $524.81 | $616.60 | $851.14 |
Medcost Setting Professional Modifier None Typical Low $467.74 Median $575.44 Typical High $575.44 | Professional | None | $467.74 | $575.44 | $575.44 |
Sentara Setting Facility Modifier None Typical Low $407.38 Median $1,778.28 Typical High $8,709.64 | Facility | None | $407.38 | $1,778.28 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $426.58 Median $602.56 Typical High $2,187.76 | Professional | None | $426.58 | $602.56 | $2,187.76 |
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 $380.19 Median $588.84 Typical High $933.25 | Professional | None | $380.19 | $588.84 | $933.25 |
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 $208.93 Median $263.03 Typical High $263.03 | Professional | 52 · Reduced service | $208.93 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $104.71 Typical High $104.71 | Professional | 53 · Discontinued | $83.18 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $389.05 Typical High $389.05 | Professional | 54 · Surgery only | $309.03 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $63.10 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $52.48 Typical High $52.48 | Professional | 56 · Pre-op care only | $41.69 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $363.08 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $288.40 | $363.08 | $363.08 |
Where Virginia sits
The same service costs 6.5 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· 37th of 51
$562
AK $1,995TX $309
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.