How much rates vary
Facilitymedian $1,349 · 10th to 90th $214 to $5,495Professionalmedian $214 · 10th to 90th $158 to $309
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 $223.87 Median $389.05 Typical High $8,317.64 | Facility | None | $223.87 | $389.05 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $234.42 Typical High $371.54 | Professional | None | $169.82 | $234.42 | $371.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $3,715.35 Typical High $4,265.80 | Facility | None | $2,884.03 | $3,715.35 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $158.49 Median $208.93 Typical High $288.40 | Professional | None | $158.49 | $208.93 | $288.40 |
CareFirst Setting Professional Modifier None Typical Low $158.49 Median $177.83 Typical High $208.93 | Professional | None | $158.49 | $177.83 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $812.83 Typical High $1,659.59 | Facility | None | $346.74 | $812.83 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $218.78 Typical High $295.12 | Professional | None | $162.18 | $218.78 | $295.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $208.93 Median $275.42 Typical High $331.13 | Professional | None | $208.93 | $275.42 | $331.13 |
Medcost Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $302.00 | Professional | None | $263.03 | $263.03 | $302.00 |
Medcost Setting Facility Modifier None Typical Low $181.97 Median $245.47 Typical High $398.11 | Facility | None | $181.97 | $245.47 | $398.11 |
Medcost Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
Sentara Setting Facility Modifier None Typical Low $131.83 Median $891.25 Typical High $3,630.78 | Facility | None | $131.83 | $891.25 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $158.49 Median $263.03 Typical High $2,137.96 | Professional | None | $158.49 | $263.03 | $2,137.96 |
United Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $5,888.44 | Facility | None | $588.84 | $2,187.76 | $5,888.44 |
United Setting Professional Modifier None Typical Low $131.83 Median $204.17 Typical High $354.81 | Professional | None | $131.83 | $204.17 | $354.81 |
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 $83.18 Median $93.33 Typical High $123.03 | Professional | 52 · Reduced service | $83.18 | $93.33 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $37.15 Typical High $48.98 | Professional | 53 · Discontinued | $33.88 | $37.15 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $138.04 Typical High $181.97 | Professional | 54 · Surgery only | $125.89 | $138.04 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $27.54 Typical High $37.15 | Professional | 55 · Aftercare only | $25.12 | $27.54 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $18.20 Typical High $24.55 | Professional | 56 · Pre-op care only | $16.98 | $18.20 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $128.82 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $117.49 | $128.82 | $169.82 |
Where Virginia sits
The same service costs 4.6 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· 39th of 51
$219
AK $794KY $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.