How much rates vary
Facilitymedian $1,445 · 10th to 90th $501 to $5,370Professionalmedian $1,023 · 10th to 90th $794 to $1,445
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 $1,071.52 Median $5,370.32 Typical High $14,125.38 | Facility | None | $1,071.52 | $5,370.32 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,071.52 Typical High $1,230.27 | Professional | None | $1,000.00 | $1,071.52 | $1,230.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $2,398.83 Typical High $2,951.21 | Facility | None | $1,698.24 | $2,398.83 | $2,951.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,096.48 Typical High $1,318.26 | Professional | None | $912.01 | $1,096.48 | $1,318.26 |
CareFirst Setting Professional Modifier None Typical Low $912.01 Median $1,023.29 Typical High $1,202.26 | Professional | None | $912.01 | $1,023.29 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $691.83 Typical High $2,570.40 | Facility | None | $489.78 | $691.83 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $933.25 Typical High $1,445.44 | Professional | None | $724.44 | $933.25 | $1,445.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $891.25 Median $1,071.52 Typical High $1,380.38 | Professional | None | $891.25 | $1,071.52 | $1,380.38 |
Medcost Setting Professional Modifier None Typical Low $954.99 Median $1,202.26 Typical High $1,202.26 | Professional | None | $954.99 | $1,202.26 | $1,202.26 |
Medcost Setting Facility Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,778.28 | Facility | None | $1,071.52 | $1,071.52 | $1,778.28 |
Medcost Setting Professional Modifier None Typical Low $436.52 Median $524.81 Typical High $933.25 | Professional | None | $436.52 | $524.81 | $933.25 |
Sentara Setting Facility Modifier None Typical Low $616.60 Median $1,202.26 Typical High $4,365.16 | Facility | None | $616.60 | $1,202.26 | $4,365.16 |
Sentara Setting Professional Modifier None Typical Low $794.33 Median $954.99 Typical High $2,187.76 | Professional | None | $794.33 | $954.99 | $2,187.76 |
United Setting Facility Modifier None Typical Low $323.59 Median $1,445.44 Typical High $3,630.78 | Facility | None | $323.59 | $1,445.44 | $3,630.78 |
United Setting Professional Modifier None Typical Low $630.96 Median $851.14 Typical High $1,698.24 | Professional | None | $630.96 | $851.14 | $1,698.24 |
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 $501.19 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $501.19 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $199.53 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $741.31 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $151.36 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $100.00 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $691.83 | $758.58 | $758.58 |
Where Virginia sits
The same service costs 22.4 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· 30th of 51
$1,047
AK $3,981TX $178
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.