How much rates vary
Facilitymedian $1,288 · 10th to 90th $316 to $5,623Professionalmedian $309 · 10th to 90th $234 to $447
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 $323.59 Median $457.09 Typical High $7,244.36 | Facility | None | $323.59 | $457.09 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $331.13 Typical High $537.03 | Professional | None | $251.19 | $331.13 | $537.03 |
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 $239.88 Median $302.00 Typical High $416.87 | Professional | None | $239.88 | $302.00 | $416.87 |
CareFirst Setting Professional Modifier None Typical Low $239.88 Median $269.15 Typical High $316.23 | Professional | None | $239.88 | $269.15 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $870.96 Typical High $2,187.76 | Facility | None | $478.63 | $870.96 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $309.03 Typical High $416.87 | Professional | None | $239.88 | $309.03 | $416.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $302.00 Median $398.11 Typical High $467.74 | Professional | None | $302.00 | $398.11 | $467.74 |
Medcost Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $380.19 | Professional | None | $323.59 | $323.59 | $380.19 |
Medcost Setting Facility Modifier None Typical Low $275.42 Median $354.81 Typical High $575.44 | Facility | None | $275.42 | $354.81 | $575.44 |
Medcost Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
Sentara Setting Facility Modifier None Typical Low $169.82 Median $933.25 Typical High $3,630.78 | Facility | None | $169.82 | $933.25 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $218.78 Median $371.54 Typical High $2,137.96 | Professional | None | $218.78 | $371.54 | $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 $194.98 Median $281.84 Typical High $512.86 | Professional | None | $194.98 | $281.84 | $512.86 |
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 $125.89 Median $138.04 Typical High $177.83 | Professional | 52 · Reduced service | $125.89 | $138.04 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $54.95 Typical High $70.79 | Professional | 53 · Discontinued | $50.12 | $54.95 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $208.93 Typical High $263.03 | Professional | 54 · Surgery only | $190.55 | $208.93 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $41.69 Typical High $52.48 | Professional | 55 · Aftercare only | $38.02 | $41.69 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $27.54 Typical High $35.48 | Professional | 56 · Pre-op care only | $25.12 | $27.54 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $194.98 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $177.83 | $194.98 | $245.47 |
Where Virginia sits
The same service costs 4.8 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· 31st of 51
$324
AK $1,202KY $251
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.