How much rates vary
Facilitymedian $7,943 · 10th to 90th $339 to $18,197Professionalmedian $355 · 10th to 90th $251 to $3,981
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 $234.42 Median $7,762.47 Typical High $15,488.17 | Professional | None (both parts) | $234.42 | $7,762.47 | $15,488.17 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $245.47 Median $295.12 Typical High $295.12 | Professional | 26 · Professional part | $245.47 | $295.12 | $295.12 |
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 $251.19 Median $251.19 Typical High $251.19 | Professional | None (both parts) | $251.19 | $251.19 | $251.19 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $234.42 Median $281.84 Typical High $354.81 | Professional | 26 · Professional part | $234.42 | $281.84 | $354.81 |
Anthem BCBS Setting Professional Modifier TC · Technical part Typical Low $331.13 Median $389.05 Typical High $489.78 | Professional | TC · Technical part | $331.13 | $389.05 | $489.78 |
CareFirst Setting Professional Modifier None (both parts) Typical Low $263.03 Median $295.12 Typical High $2,951.21 | Professional | None (both parts) | $263.03 | $295.12 | $2,951.21 |
CareFirst Setting Professional Modifier 26 · Professional part Typical Low $251.19 Median $275.42 Typical High $346.74 | Professional | 26 · Professional part | $251.19 | $275.42 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $8,709.64 Median $8,709.64 Typical High $11,220.18 | Facility | None | $8,709.64 | $8,709.64 | $11,220.18 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $251.19 Median $346.74 Typical High $562.34 | Professional | 26 · Professional part | $251.19 | $346.74 | $562.34 |
Kaiser Permanente Setting Professional Modifier None Typical Low $251.19 Median $288.40 Typical High $371.54 | Professional | None | $251.19 | $288.40 | $371.54 |
Medcost Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $457.09 | Facility | None | $295.12 | $295.12 | $457.09 |
Medcost Setting Professional Modifier None (both parts) Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None (both parts) | $281.84 | $281.84 | $281.84 |
Sentara Setting Facility Modifier None Typical Low $229.09 Median $371.54 Typical High $12,022.64 | Facility | None | $229.09 | $371.54 | $12,022.64 |
Sentara Setting Professional Modifier None (both parts) Typical Low $269.15 Median $346.74 Typical High $1,230.27 | Professional | None (both parts) | $269.15 | $346.74 | $1,230.27 |
Sentara Setting Professional Modifier 26 · Professional part Typical Low $269.15 Median $354.81 Typical High $630.96 | Professional | 26 · Professional part | $269.15 | $354.81 | $630.96 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $8,511.38 Typical High $20,417.38 | Facility | None | $1,995.26 | $8,511.38 | $20,417.38 |
United Setting Professional Modifier None (both parts) Typical Low $234.42 Median $389.05 Typical High $575.44 | Professional | None (both parts) | $234.42 | $389.05 | $575.44 |
United Setting Professional Modifier 26 · Professional part Typical Low $234.42 Median $389.05 Typical High $575.44 | Professional | 26 · Professional part | $234.42 | $389.05 | $575.44 |
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 $117.49 Median $120.23 Typical High $151.36 | Professional | 52 · Reduced service | $117.49 | $120.23 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $48.98 Typical High $60.26 | Professional | 53 · Discontinued | $46.77 | $48.98 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $181.97 Typical High $223.87 | Professional | 54 · Surgery only | $177.83 | $181.97 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $36.31 Typical High $45.71 | Professional | 55 · Aftercare only | $35.48 | $36.31 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $24.55 Typical High $30.20 | Professional | 56 · Pre-op care only | $23.44 | $24.55 | $30.20 |
Where Virginia sits
The same service costs 19.5 times more in Colorado than in Maryland. 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
$631
CO $6,761MD $347
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.