How much rates vary
Facilitymedian $372 · 10th to 90th $102 to $3,236Professionalmedian $145 · 10th to 90th $100 to $209
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 $123.03 Median $208.93 Typical High $7,079.46 | Facility | None | $123.03 | $208.93 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $151.36 Typical High $234.42 | Professional | None | $107.15 | $151.36 | $234.42 |
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 $141.25 Typical High $194.98 | Professional | None | $100.00 | $141.25 | $194.98 |
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 $117.49 Typical High $218.78 | Facility | None | $50.12 | $117.49 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $147.91 Typical High $208.93 | Professional | None | $104.71 | $147.91 | $208.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $144.54 Median $190.55 Typical High $223.87 | Professional | None | $144.54 | $190.55 | $223.87 |
Medcost Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $208.93 | Professional | None | $147.91 | $147.91 | $208.93 |
Medcost Setting Facility Modifier None Typical Low $114.82 Median $169.82 Typical High $275.42 | Facility | None | $114.82 | $169.82 | $275.42 |
Medcost Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
Sentara Setting Facility Modifier None Typical Low $83.18 Median $371.54 Typical High $2,454.71 | Facility | None | $83.18 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $107.15 Median $173.78 Typical High $933.25 | Professional | None | $107.15 | $173.78 | $933.25 |
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 $83.18 Median $138.04 Typical High $239.88 | Professional | None | $83.18 | $138.04 | $239.88 |
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 $61.66 Typical High $85.11 | Professional | 52 · Reduced service | $53.70 | $61.66 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $24.55 Typical High $33.88 | Professional | 53 · Discontinued | $21.38 | $24.55 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $91.20 Typical High $125.89 | Professional | 54 · Surgery only | $81.28 | $91.20 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $18.62 Typical High $25.12 | Professional | 55 · Aftercare only | $16.22 | $18.62 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $12.30 Typical High $16.98 | Professional | 56 · Pre-op care only | $10.72 | $12.30 | $16.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $85.11 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $75.86 | $85.11 | $117.49 |
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· 34th of 51
$145
AK $447KY $110
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.