How much rates vary
Facilitymedian $2,570 · 10th to 90th $437 to $9,772Professionalmedian $437 · 10th to 90th $355 to $708
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 $812.83 Typical High $10,964.78 | Facility | None | $426.58 | $812.83 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $426.58 Typical High $851.14 | Professional | None | $371.54 | $426.58 | $851.14 |
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 $354.81 Median $426.58 Typical High $537.03 | Professional | None | $354.81 | $426.58 | $537.03 |
CareFirst Setting Professional Modifier None Typical Low $371.54 Median $407.38 Typical High $3,162.28 | Professional | None | $371.54 | $407.38 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $1,819.70 Typical High $3,467.37 | Facility | None | $724.44 | $1,819.70 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $426.58 Typical High $660.69 | Professional | None | $363.08 | $426.58 | $660.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $316.23 Median $478.63 Typical High $602.56 | Professional | None | $316.23 | $478.63 | $602.56 |
Medcost Setting Professional Modifier None Typical Low $524.81 Median $660.69 Typical High $660.69 | Professional | None | $524.81 | $660.69 | $660.69 |
Medcost Setting Facility Modifier None Typical Low $407.38 Median $478.63 Typical High $707.95 | Facility | None | $407.38 | $478.63 | $707.95 |
Medcost Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
Sentara Setting Facility Modifier None Typical Low $331.13 Median $1,445.44 Typical High $8,709.64 | Facility | None | $331.13 | $1,445.44 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $407.38 Median $512.86 Typical High $4,570.88 | Professional | None | $407.38 | $512.86 | $4,570.88 |
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 $302.00 Median $501.19 Typical High $741.31 | Professional | None | $302.00 | $501.19 | $741.31 |
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 $186.21 Median $204.17 Typical High $218.78 | Professional | 52 · Reduced service | $186.21 | $204.17 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $81.28 Typical High $87.10 | Professional | 53 · Discontinued | $74.13 | $81.28 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $309.03 Typical High $331.13 | Professional | 54 · Surgery only | $281.84 | $309.03 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $61.66 Typical High $66.07 | Professional | 55 · Aftercare only | $56.23 | $61.66 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $40.74 Typical High $43.65 | Professional | 56 · Pre-op care only | $37.15 | $40.74 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $288.40 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $263.03 | $288.40 | $309.03 |
Where Virginia sits
The same service costs 3.8 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
$447
AK $1,349UT $355
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.