How much rates vary
Facilitymedian $407 · 10th to 90th $151 to $3,236Professionalmedian $219 · 10th to 90th $170 to $302
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 $213.80 Median $302.00 Typical High $5,754.40 | Facility | None | $213.80 | $302.00 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $229.09 Typical High $354.81 | Professional | None | $177.83 | $229.09 | $354.81 |
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 $173.78 Median $218.78 Typical High $281.84 | Professional | None | $173.78 | $218.78 | $281.84 |
CareFirst Setting Professional Modifier None Typical Low $181.97 Median $199.53 Typical High $234.42 | Professional | None | $181.97 | $199.53 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $251.19 Typical High $1,621.81 | Facility | None | $131.83 | $251.19 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $218.78 Typical High $302.00 | Professional | None | $181.97 | $218.78 | $302.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $199.53 Median $263.03 Typical High $309.03 | Professional | None | $199.53 | $263.03 | $309.03 |
Medcost Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $316.23 | Professional | None | $229.09 | $229.09 | $316.23 |
Medcost Setting Facility Modifier None Typical Low $204.17 Median $229.09 Typical High $371.54 | Facility | None | $204.17 | $229.09 | $371.54 |
Medcost Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
Sentara Setting Facility Modifier None Typical Low $151.36 Median $398.11 Typical High $2,454.71 | Facility | None | $151.36 | $398.11 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $181.97 Median $239.88 Typical High $1,071.52 | Professional | None | $181.97 | $239.88 | $1,071.52 |
United Setting Facility Modifier None Typical Low $100.00 Median $660.69 Typical High $2,041.74 | Facility | None | $100.00 | $660.69 | $2,041.74 |
United Setting Professional Modifier None Typical Low $141.25 Median $199.53 Typical High $338.84 | Professional | None | $141.25 | $199.53 | $338.84 |
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 $89.13 Median $100.00 Typical High $114.82 | Professional | 52 · Reduced service | $89.13 | $100.00 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $40.74 Typical High $45.71 | Professional | 53 · Discontinued | $35.48 | $40.74 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $151.36 Typical High $173.78 | Professional | 54 · Surgery only | $134.90 | $151.36 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $30.20 Typical High $34.67 | Professional | 55 · Aftercare only | $26.92 | $30.20 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $20.42 Typical High $22.91 | Professional | 56 · Pre-op care only | $17.78 | $20.42 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $141.25 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $125.89 | $141.25 | $162.18 |
Where Virginia sits
The same service costs 4.4 times more in Alaska than in Florida. 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· 33rd of 51
$219
AK $759FL $174
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.