How much rates vary
Facilitymedian $1,288 · 10th to 90th $263 to $4,786Professionalmedian $275 · 10th to 90th $214 to $389
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 $295.12 Median $3,235.94 Typical High $9,332.54 | Facility | None | $295.12 | $3,235.94 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $295.12 Typical High $426.58 | Professional | None | $223.87 | $295.12 | $426.58 |
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 $213.80 Median $275.42 Typical High $363.08 | Professional | None | $213.80 | $275.42 | $363.08 |
CareFirst Setting Professional Modifier None Typical Low $218.78 Median $239.88 Typical High $288.40 | Professional | None | $218.78 | $239.88 | $288.40 |
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 $218.78 Median $275.42 Typical High $389.05 | Professional | None | $218.78 | $275.42 | $389.05 |
Kaiser Permanente Setting Professional Modifier None Typical Low $263.03 Median $338.84 Typical High $407.38 | Professional | None | $263.03 | $338.84 | $407.38 |
Medcost Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $426.58 | Professional | None | $363.08 | $363.08 | $426.58 |
Medcost Setting Facility Modifier None Typical Low $257.04 Median $316.23 Typical High $512.86 | Facility | None | $257.04 | $316.23 | $512.86 |
Medcost Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | None | $602.56 | $602.56 | $602.56 |
Sentara Setting Facility Modifier None Typical Low $199.53 Median $616.60 Typical High $2,951.21 | Facility | None | $199.53 | $616.60 | $2,951.21 |
Sentara Setting Professional Modifier None Typical Low $208.93 Median $338.84 Typical High $1,737.80 | Professional | None | $208.93 | $338.84 | $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 $186.21 Median $269.15 Typical High $457.09 | Professional | None | $186.21 | $269.15 | $457.09 |
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 $114.82 Median $125.89 Typical High $158.49 | Professional | 52 · Reduced service | $114.82 | $125.89 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $51.29 Typical High $63.10 | Professional | 53 · Discontinued | $45.71 | $51.29 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $190.55 Typical High $234.42 | Professional | 54 · Surgery only | $169.82 | $190.55 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $38.02 Typical High $46.77 | Professional | 55 · Aftercare only | $33.88 | $38.02 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $25.70 Typical High $31.62 | Professional | 56 · Pre-op care only | $22.91 | $25.70 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $177.83 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $158.49 | $177.83 | $218.78 |
Where Virginia sits
The same service costs 3.9 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· 37th of 51
$288
AK $912KY $234
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.