How much rates vary
Facilitymedian $3,802 · 10th to 90th $513 to $10,965Professionalmedian $525 · 10th to 90th $427 to $813
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 $501.19 Median $4,786.30 Typical High $14,125.38 | Facility | None | $501.19 | $4,786.30 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $501.19 Typical High $3,467.37 | Professional | None | $436.52 | $501.19 | $3,467.37 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,818.38 Median $6,760.83 Typical High $12,882.50 | Facility | None | $2,818.38 | $6,760.83 | $12,882.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $436.52 Median $524.81 Typical High $676.08 | Professional | None | $436.52 | $524.81 | $676.08 |
CareFirst Setting Professional Modifier None Typical Low $457.09 Median $512.86 Typical High $776.25 | Professional | None | $457.09 | $512.86 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $794.33 Typical High $5,495.41 | Facility | None | $501.19 | $794.33 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $501.19 Typical High $776.25 | Professional | None | $446.68 | $501.19 | $776.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $398.11 Median $478.63 Typical High $588.84 | Professional | None | $398.11 | $478.63 | $588.84 |
Medcost Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $758.58 | Professional | None | $602.56 | $758.58 | $758.58 |
Medcost Setting Facility Modifier None Typical Low $501.19 Median $588.84 Typical High $812.83 | Facility | None | $501.19 | $588.84 | $812.83 |
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 $389.05 Median $1,288.25 Typical High $5,128.61 | Facility | None | $389.05 | $1,288.25 | $5,128.61 |
Sentara Setting Professional Modifier None Typical Low $407.38 Median $575.44 Typical High $2,089.30 | Professional | None | $407.38 | $575.44 | $2,089.30 |
United Setting Facility Modifier None Typical Low $436.52 Median $2,344.23 Typical High $6,309.57 | Facility | None | $436.52 | $2,344.23 | $6,309.57 |
United Setting Professional Modifier None Typical Low $371.54 Median $575.44 Typical High $891.25 | Professional | None | $371.54 | $575.44 | $891.25 |
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 $213.80 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $213.80 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $85.11 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $371.54 Typical High $371.54 | Professional | 54 · Surgery only | $323.59 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $74.13 Typical High $74.13 | Professional | 55 · Aftercare only | $64.57 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $42.66 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $346.74 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $302.00 | $346.74 | $346.74 |
Where Virginia sits
The same service costs 7.2 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· 35th of 51
$550
OK $2,042UT $282
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.