How much rates vary
Facilitymedian $417 · 10th to 90th $110 to $3,388Professionalmedian $145 · 10th to 90th $102 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 $144.54 Median $229.09 Typical High $7,079.46 | Facility | None | $144.54 | $229.09 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $158.49 Typical High $234.42 | Professional | None | $109.65 | $158.49 | $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 $144.54 Typical High $199.53 | Professional | None | $100.00 | $144.54 | $199.53 |
CareFirst Setting Professional Modifier None Typical Low $102.33 Median $114.82 Typical High $134.90 | Professional | None | $102.33 | $114.82 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $295.12 Typical High $1,621.81 | Facility | None | $109.65 | $295.12 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $151.36 Typical High $204.17 | Professional | None | $102.33 | $151.36 | $204.17 |
Kaiser Permanente Setting Professional Modifier None Typical Low $141.25 Median $186.21 Typical High $218.78 | Professional | None | $141.25 | $186.21 | $218.78 |
Medcost Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $199.53 | Professional | None | $177.83 | $177.83 | $199.53 |
Medcost Setting Facility Modifier None Typical Low $117.49 Median $169.82 Typical High $275.42 | Facility | None | $117.49 | $169.82 | $275.42 |
Medcost Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
Sentara Setting Facility Modifier None Typical Low $85.11 Median $371.54 Typical High $2,454.71 | Facility | None | $85.11 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $107.15 Median $177.83 Typical High $933.25 | Professional | None | $107.15 | $177.83 | $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 $85.11 Median $138.04 Typical High $239.88 | Professional | None | $85.11 | $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 $54.95 Median $63.10 Typical High $83.18 | Professional | 52 · Reduced service | $54.95 | $63.10 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $25.12 Typical High $33.88 | Professional | 53 · Discontinued | $21.88 | $25.12 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $93.33 Typical High $125.89 | Professional | 54 · Surgery only | $81.28 | $93.33 | $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 $10.96 Median $12.59 Typical High $16.98 | Professional | 56 · Pre-op care only | $10.96 | $12.59 | $16.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $87.10 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $75.86 | $87.10 | $117.49 |
Where Virginia sits
The same service costs 3.7 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· 27th of 51
$151
AK $427KY $115
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.