How much rates vary
Facilitymedian $490 · 10th to 90th $85 to $4,074Professionalmedian $141 · 10th to 90th $85 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 $104.71 Median $2,041.74 Typical High $8,317.64 | Facility | None | $104.71 | $2,041.74 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $147.91 Typical High $218.78 | Professional | None | $85.11 | $147.91 | $218.78 |
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 $89.13 Median $141.25 Typical High $204.17 | Professional | None | $89.13 | $141.25 | $204.17 |
CareFirst Setting Professional Modifier None Typical Low $89.13 Median $97.72 Typical High $114.82 | Professional | None | $89.13 | $97.72 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $1,230.27 | Facility | None | $50.12 | $50.12 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $141.25 Typical High $218.78 | Professional | None | $85.11 | $141.25 | $218.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $147.91 Median $194.98 Typical High $234.42 | Professional | None | $147.91 | $194.98 | $234.42 |
Medcost Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $151.36 | Professional | None | $97.72 | $97.72 | $151.36 |
Medcost Setting Facility Modifier None Typical Low $85.11 Median $154.88 Typical High $309.03 | Facility | None | $85.11 | $154.88 | $309.03 |
Medcost Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Sentara Setting Facility Modifier None Typical Low $56.23 Median $302.00 Typical High $2,454.71 | Facility | None | $56.23 | $302.00 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $64.57 Median $186.21 Typical High $1,071.52 | Professional | None | $64.57 | $186.21 | $1,071.52 |
United Setting Facility Modifier None Typical Low $100.00 Median $660.69 Typical High $2,041.74 | Facility | None | $100.00 | $660.69 | $2,041.74 |
United Setting Professional Modifier None Typical Low $66.07 Median $131.83 Typical High $245.47 | Professional | None | $66.07 | $131.83 | $245.47 |
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 $42.66 Median $61.66 Typical High $79.43 | Professional | 52 · Reduced service | $42.66 | $61.66 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $25.12 Typical High $31.62 | Professional | 53 · Discontinued | $16.98 | $25.12 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $93.33 Typical High $120.23 | Professional | 54 · Surgery only | $64.57 | $93.33 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $18.62 Typical High $23.99 | Professional | 55 · Aftercare only | $12.88 | $18.62 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $12.30 Typical High $15.85 | Professional | 56 · Pre-op care only | $8.51 | $12.30 | $15.85 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $60.26 Median $87.10 Typical High $112.20 | Professional | 78 · Unplanned return to OR | $60.26 | $87.10 | $112.20 |
Where Virginia sits
The same service costs 4.5 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
$151
AK $407KY $91.20
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.