How much rates vary
Facilitymedian $1,023 · 10th to 90th $251 to $4,786Professionalmedian $288 · 10th to 90th $200 to $427
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 $288.40 Median $602.56 Typical High $8,317.64 | Facility | None | $288.40 | $602.56 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $316.23 Typical High $467.74 | Professional | None | $213.80 | $316.23 | $467.74 |
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 $199.53 Median $281.84 Typical High $398.11 | Professional | None | $199.53 | $281.84 | $398.11 |
CareFirst Setting Professional Modifier None Typical Low $204.17 Median $223.87 Typical High $263.03 | Professional | None | $204.17 | $223.87 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $602.56 Typical High $2,187.76 | Facility | None | $398.11 | $602.56 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $295.12 Typical High $416.87 | Professional | None | $204.17 | $295.12 | $416.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $281.84 Median $371.54 Typical High $436.52 | Professional | None | $281.84 | $371.54 | $436.52 |
Medcost Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $363.08 | Professional | None | $316.23 | $316.23 | $363.08 |
Medcost Setting Facility Modifier None Typical Low $239.88 Median $346.74 Typical High $575.44 | Facility | None | $239.88 | $346.74 | $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 $144.54 Median $616.60 Typical High $2,951.21 | Facility | None | $144.54 | $616.60 | $2,951.21 |
Sentara Setting Professional Modifier None Typical Low $213.80 Median $371.54 Typical High $1,737.80 | Professional | None | $213.80 | $371.54 | $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 $173.78 Median $275.42 Typical High $489.78 | Professional | None | $173.78 | $275.42 | $489.78 |
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 $107.15 Median $125.89 Typical High $173.78 | Professional | 52 · Reduced service | $107.15 | $125.89 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $50.12 Typical High $70.79 | Professional | 53 · Discontinued | $42.66 | $50.12 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $190.55 Typical High $263.03 | Professional | 54 · Surgery only | $162.18 | $190.55 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $38.02 Typical High $52.48 | Professional | 55 · Aftercare only | $32.36 | $38.02 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $25.12 Typical High $34.67 | Professional | 56 · Pre-op care only | $21.38 | $25.12 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $177.83 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $151.36 | $177.83 | $245.47 |
Where Virginia sits
The same service costs 3.6 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· 30th of 51
$302
AK $851KY $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.