How much rates vary
Facilitymedian $1,148 · 10th to 90th $117 to $4,786Professionalmedian $138 · 10th to 90th $100 to $195
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 $3,981.07 Typical High $9,332.54 | Facility | None | $151.36 | $3,981.07 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $151.36 Typical High $229.09 | Professional | None | $109.65 | $151.36 | $229.09 |
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 $134.90 Typical High $186.21 | Professional | None | $100.00 | $134.90 | $186.21 |
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 $104.71 Median $288.40 Typical High $1,621.81 | Facility | None | $104.71 | $288.40 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $138.04 Typical High $190.55 | Professional | None | $104.71 | $138.04 | $190.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $169.82 Typical High $204.17 | Professional | None | $128.82 | $169.82 | $204.17 |
Medcost Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $194.98 | Professional | None | $177.83 | $177.83 | $194.98 |
Medcost Setting Facility Modifier None Typical Low $114.82 Median $151.36 Typical High $251.19 | Facility | None | $114.82 | $151.36 | $251.19 |
Medcost Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
Sentara Setting Facility Modifier None Typical Low $89.13 Median $616.60 Typical High $2,951.21 | Facility | None | $89.13 | $616.60 | $2,951.21 |
Sentara Setting Professional Modifier None Typical Low $100.00 Median $162.18 Typical High $1,778.28 | Professional | None | $100.00 | $162.18 | $1,778.28 |
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 $85.11 Median $131.83 Typical High $218.78 | Professional | None | $85.11 | $131.83 | $218.78 |
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 $57.54 Typical High $75.86 | Professional | 52 · Reduced service | $54.95 | $57.54 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $23.44 Typical High $30.90 | Professional | 53 · Discontinued | $21.88 | $23.44 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $87.10 Typical High $114.82 | Professional | 54 · Surgery only | $83.18 | $87.10 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $17.38 Typical High $22.91 | Professional | 55 · Aftercare only | $16.60 | $17.38 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $11.48 Typical High $15.14 | Professional | 56 · Pre-op care only | $10.96 | $11.48 | $15.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $81.28 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $77.62 | $81.28 | $107.15 |
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· 27th of 51
$141
AK $437KY $107
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.