How much rates vary
Facilitymedian $1,862 · 10th to 90th $195 to $6,026Professionalmedian $263 · 10th to 90th $174 to $380
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 $173.78 Median $4,365.16 Typical High $10,000.00 | Facility | None | $173.78 | $4,365.16 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $263.03 Typical High $302.00 | Professional | None | $169.82 | $263.03 | $302.00 |
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 $177.83 Median $263.03 Typical High $363.08 | Professional | None | $177.83 | $263.03 | $363.08 |
CareFirst Setting Professional Modifier None Typical Low $186.21 Median $208.93 Typical High $245.47 | Professional | None | $186.21 | $208.93 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $194.98 Typical High $363.08 | Facility | None | $50.12 | $194.98 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $281.84 Typical High $380.19 | Professional | None | $190.55 | $281.84 | $380.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $269.15 Median $346.74 Typical High $416.87 | Professional | None | $269.15 | $346.74 | $416.87 |
Medcost Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $380.19 | Professional | None | $288.40 | $288.40 | $380.19 |
Medcost Setting Facility Modifier None Typical Low $169.82 Median $263.03 Typical High $524.81 | Facility | None | $169.82 | $263.03 | $524.81 |
Medcost Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
Sentara Setting Facility Modifier None Typical Low $165.96 Median $933.25 Typical High $3,630.78 | Facility | None | $165.96 | $933.25 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $199.53 Median $331.13 Typical High $2,570.40 | Professional | None | $199.53 | $331.13 | $2,570.40 |
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 $169.82 Median $263.03 Typical High $436.52 | Professional | None | $169.82 | $263.03 | $436.52 |
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 $85.11 Median $104.71 Typical High $138.04 | Professional | 52 · Reduced service | $85.11 | $104.71 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $41.69 Typical High $54.95 | Professional | 53 · Discontinued | $33.88 | $41.69 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $154.88 Typical High $204.17 | Professional | 54 · Surgery only | $128.82 | $154.88 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $31.62 Typical High $40.74 | Professional | 55 · Aftercare only | $25.70 | $31.62 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $20.89 Typical High $27.54 | Professional | 56 · Pre-op care only | $16.98 | $20.89 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $144.54 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $120.23 | $144.54 | $190.55 |
Where Virginia sits
The same service costs 3.5 times more in Alaska than in Texas. 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· 36th of 51
$269
AK $759TX $214
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.