How much rates vary
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 $1,348.96 Median $5,370.32 Typical High $14,125.38 | Facility | None | $1,348.96 | $5,370.32 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $1,348.96 Typical High $3,388.44 | Professional | None | $831.76 | $1,348.96 | $3,388.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $6,456.54 Typical High $7,244.36 | Facility | None | $4,677.35 | $6,456.54 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,174.90 Typical High $1,380.38 | Professional | None | $977.24 | $1,174.90 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,479.11 Median $1,778.28 Typical High $2,089.30 | Professional | 50 · Both sides | $1,479.11 | $1,778.28 | $2,089.30 |
CareFirst Setting Professional Modifier None Typical Low $977.24 Median $1,096.48 Typical High $1,288.25 | Professional | None | $977.24 | $1,096.48 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,778.28 Typical High $3,311.31 | Facility | None | $524.81 | $1,778.28 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,023.29 Typical High $1,479.11 | Professional | None | $870.96 | $1,023.29 | $1,479.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $891.25 Median $1,023.29 Typical High $1,288.25 | Professional | None | $891.25 | $1,023.29 | $1,288.25 |
Medcost Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,318.26 | Professional | None | $1,202.26 | $1,202.26 | $1,318.26 |
Medcost Setting Facility Modifier None Typical Low $831.76 Median $1,174.90 Typical High $1,778.28 | Facility | None | $831.76 | $1,174.90 | $1,778.28 |
Medcost Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,174.90 | $1,174.90 | $1,174.90 |
Sentara Setting Facility Modifier None Typical Low $776.25 Median $2,238.72 Typical High $10,232.93 | Facility | None | $776.25 | $2,238.72 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $776.25 Median $1,148.15 Typical High $6,025.60 | Professional | None | $776.25 | $1,148.15 | $6,025.60 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $6,760.83 Typical High $17,378.01 | Facility | None | $1,548.82 | $6,760.83 | $17,378.01 |
United Setting Professional Modifier None Typical Low $707.95 Median $954.99 Typical High $1,621.81 | Professional | None | $707.95 | $954.99 | $1,621.81 |
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 $416.87 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $416.87 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $169.82 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $630.96 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $125.89 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $83.18 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $588.84 | $954.99 | $954.99 |
Where Virginia sits
The same service costs 7.2 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· 35th of 51
$1,175
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.