How much rates vary
Facilitymedian $794 · 10th to 90th $123 to $4,365Professionalmedian $148 · 10th to 90th $105 to $219
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 $151.36 Median $245.47 Typical High $7,244.36 | Facility | None | $151.36 | $245.47 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $165.96 Typical High $245.47 | Professional | None | $112.20 | $165.96 | $245.47 |
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 $104.71 Median $144.54 Typical High $199.53 | Professional | None | $104.71 | $144.54 | $199.53 |
CareFirst Setting Professional Modifier None Typical Low $104.71 Median $117.49 Typical High $138.04 | Professional | None | $104.71 | $117.49 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $288.40 Typical High $1,621.81 | Facility | None | $107.15 | $288.40 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $154.88 Typical High $208.93 | Professional | None | $104.71 | $154.88 | $208.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $144.54 Median $190.55 Typical High $229.09 | Professional | None | $144.54 | $190.55 | $229.09 |
Medcost Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $218.78 | Professional | None | $190.55 | $190.55 | $218.78 |
Medcost Setting Facility Modifier None Typical Low $123.03 Median $173.78 Typical High $288.40 | Facility | None | $123.03 | $173.78 | $288.40 |
Medcost Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
Sentara Setting Facility Modifier None Typical Low $95.50 Median $616.60 Typical High $2,951.21 | Facility | None | $95.50 | $616.60 | $2,951.21 |
Sentara Setting Professional Modifier None Typical Low $112.20 Median $190.55 Typical High $1,737.80 | Professional | None | $112.20 | $190.55 | $1,737.80 |
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 $91.20 Median $144.54 Typical High $251.19 | Professional | None | $91.20 | $144.54 | $251.19 |
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 $56.23 Median $64.57 Typical High $87.10 | Professional | 52 · Reduced service | $56.23 | $64.57 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $25.70 Typical High $35.48 | Professional | 53 · Discontinued | $22.39 | $25.70 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $97.72 Typical High $131.83 | Professional | 54 · Surgery only | $83.18 | $97.72 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $19.50 Typical High $26.30 | Professional | 55 · Aftercare only | $16.60 | $19.50 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $12.88 Typical High $17.38 | Professional | 56 · Pre-op care only | $11.22 | $12.88 | $17.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $91.20 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $77.62 | $91.20 | $123.03 |
Where Virginia sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 32nd of 51
$155
AK $447FL $126
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.