How much rates vary
Facilitymedian $724 · 10th to 90th $115 to $4,365Professionalmedian $186 · 10th to 90th $100 to $331
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 $131.83 Median $288.40 Typical High $7,079.46 | Facility | None | $131.83 | $288.40 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $199.53 Typical High $331.13 | Professional | None | $107.15 | $199.53 | $331.13 |
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 $100.00 Median $199.53 Typical High $302.00 | Professional | None | $100.00 | $199.53 | $302.00 |
CareFirst Setting Professional Modifier None Typical Low $100.00 Median $112.20 Typical High $131.83 | Professional | None | $100.00 | $112.20 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $234.42 Typical High $436.52 | Facility | None | $50.12 | $234.42 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $190.55 Typical High $281.84 | Professional | None | $107.15 | $190.55 | $281.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $251.19 Median $331.13 Typical High $389.05 | Professional | None | $251.19 | $331.13 | $389.05 |
Medcost Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $257.04 | Professional | None | $229.09 | $229.09 | $257.04 |
Medcost Setting Facility Modifier None Typical Low $114.82 Median $186.21 Typical High $331.13 | Facility | None | $114.82 | $186.21 | $331.13 |
Medcost Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
Sentara Setting Facility Modifier None Typical Low $89.13 Median $512.86 Typical High $2,951.21 | Facility | None | $89.13 | $512.86 | $2,951.21 |
Sentara Setting Professional Modifier None Typical Low $117.49 Median $234.42 Typical High $1,778.28 | Professional | None | $117.49 | $234.42 | $1,778.28 |
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 $85.11 Median $165.96 Typical High $288.40 | Professional | None | $85.11 | $165.96 | $288.40 |
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 $53.70 Median $70.79 Typical High $134.90 | Professional | 52 · Reduced service | $53.70 | $70.79 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $28.18 Typical High $53.70 | Professional | 53 · Discontinued | $21.38 | $28.18 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $104.71 Typical High $199.53 | Professional | 54 · Surgery only | $81.28 | $104.71 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $20.89 Typical High $40.74 | Professional | 55 · Aftercare only | $16.22 | $20.89 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $14.13 Typical High $26.92 | Professional | 56 · Pre-op care only | $10.72 | $14.13 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $97.72 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $75.86 | $97.72 | $186.21 |
Where Virginia sits
The same service costs 4.1 times more in Alaska 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· 33rd of 51
$204
AK $501KY $123
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.