How much rates vary
Facilitymedian $7,762 · 10th to 90th $372 to $20,417Professionalmedian $380 · 10th to 90th $275 to $2,951
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 $4,073.80 Median $10,715.19 Typical High $19,054.61 | Facility | None | $4,073.80 | $10,715.19 | $19,054.61 |
Aetna Setting Professional Modifier None (both parts) Typical Low $263.03 Median $7,762.47 Typical High $15,488.17 | Professional | None (both parts) | $263.03 | $7,762.47 | $15,488.17 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $269.15 Median $331.13 Typical High $331.13 | Professional | 26 · Professional part | $269.15 | $331.13 | $331.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,772.37 Median $13,489.63 Typical High $14,791.08 | Facility | None | $9,772.37 | $13,489.63 | $14,791.08 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $288.40 Median $288.40 Typical High $363.08 | Professional | None (both parts) | $288.40 | $288.40 | $363.08 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $263.03 Median $309.03 Typical High $398.11 | Professional | 26 · Professional part | $263.03 | $309.03 | $398.11 |
Anthem BCBS Setting Professional Modifier TC · Technical part Typical Low $281.84 Median $331.13 Typical High $416.87 | Professional | TC · Technical part | $281.84 | $331.13 | $416.87 |
CareFirst Setting Professional Modifier None (both parts) Typical Low $275.42 Median $302.00 Typical High $426.58 | Professional | None (both parts) | $275.42 | $302.00 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $6,025.60 Typical High $50,118.72 | Facility | None | $100.00 | $6,025.60 | $50,118.72 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $281.84 Median $389.05 Typical High $630.96 | Professional | 26 · Professional part | $281.84 | $389.05 | $630.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $281.84 Median $331.13 Typical High $416.87 | Professional | None | $281.84 | $331.13 | $416.87 |
Medcost Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $501.19 | Facility | None | $331.13 | $331.13 | $501.19 |
Medcost Setting Professional Modifier None (both parts) Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None (both parts) | $309.03 | $309.03 | $309.03 |
Sentara Setting Facility Modifier None Typical Low $257.04 Median $416.87 Typical High $12,022.64 | Facility | None | $257.04 | $416.87 | $12,022.64 |
Sentara Setting Professional Modifier None (both parts) Typical Low $302.00 Median $389.05 Typical High $1,318.26 | Professional | None (both parts) | $302.00 | $389.05 | $1,318.26 |
Sentara Setting Professional Modifier 26 · Professional part Typical Low $302.00 Median $389.05 Typical High $691.83 | Professional | 26 · Professional part | $302.00 | $389.05 | $691.83 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $8,511.38 Typical High $24,547.09 | Facility | None | $1,995.26 | $8,511.38 | $24,547.09 |
United Setting Professional Modifier None (both parts) Typical Low $263.03 Median $436.52 Typical High $630.96 | Professional | None (both parts) | $263.03 | $436.52 | $630.96 |
United Setting Professional Modifier 26 · Professional part Typical Low $263.03 Median $436.52 Typical High $630.96 | Professional | 26 · Professional part | $263.03 | $436.52 | $630.96 |
5 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 $131.83 Median $134.90 Typical High $165.96 | Professional | 52 · Reduced service | $131.83 | $134.90 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $53.70 Typical High $66.07 | Professional | 53 · Discontinued | $52.48 | $53.70 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $204.17 Typical High $251.19 | Professional | 54 · Surgery only | $194.98 | $204.17 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $40.74 Typical High $50.12 | Professional | 55 · Aftercare only | $38.90 | $40.74 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.92 Typical High $33.11 | Professional | 56 · Pre-op care only | $26.30 | $26.92 | $33.11 |
Where Virginia sits
The same service costs 23.4 times more in Colorado than in Kentucky. 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· 38th of 51
$575
CO $6,761KY $288
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.