How much rates vary
Facilitymedian $562 · 10th to 90th $178 to $3,802Professionalmedian $324 · 10th to 90th $195 to $501
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 $524.81 Typical High $8,317.64 | Facility | None | $295.12 | $524.81 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $338.84 Typical High $501.19 | Professional | None | $213.80 | $338.84 | $501.19 |
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 $204.17 Median $323.59 Typical High $467.74 | Professional | None | $204.17 | $323.59 | $467.74 |
CareFirst Setting Professional Modifier None Typical Low $169.82 Median $186.21 Typical High $223.87 | Professional | None | $169.82 | $186.21 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $602.56 Typical High $2,187.76 | Facility | None | $416.87 | $602.56 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $331.13 Typical High $489.78 | Professional | None | $208.93 | $331.13 | $489.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $354.81 Median $467.74 Typical High $549.54 | Professional | None | $354.81 | $467.74 | $549.54 |
Medcost Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $407.38 | Professional | None | $346.74 | $346.74 | $407.38 |
Medcost Setting Facility Modifier None Typical Low $239.88 Median $398.11 Typical High $660.69 | Facility | None | $239.88 | $398.11 | $660.69 |
Medcost Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
Sentara Setting Facility Modifier None Typical Low $181.97 Median $416.87 Typical High $2,454.71 | Facility | None | $181.97 | $416.87 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $239.88 Median $436.52 Typical High $1,318.26 | Professional | None | $239.88 | $436.52 | $1,318.26 |
United Setting Facility Modifier None Typical Low $100.00 Median $660.69 Typical High $2,089.30 | Facility | None | $100.00 | $660.69 | $2,089.30 |
United Setting Professional Modifier None Typical Low $177.83 Median $309.03 Typical High $549.54 | Professional | None | $177.83 | $309.03 | $549.54 |
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 $147.91 Typical High $204.17 | Professional | 52 · Reduced service | $107.15 | $147.91 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $58.88 Typical High $81.28 | Professional | 53 · Discontinued | $42.66 | $58.88 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $223.87 Typical High $302.00 | Professional | 54 · Surgery only | $162.18 | $223.87 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $44.67 Typical High $61.66 | Professional | 55 · Aftercare only | $32.36 | $44.67 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $29.51 Typical High $40.74 | Professional | 56 · Pre-op care only | $21.38 | $29.51 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $208.93 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $151.36 | $208.93 | $281.84 |
Where Virginia sits
The same service costs 3.4 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· 33rd of 51
$347
AK $871KY $257
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.