How much rates vary
Facilitymedian $417 · 10th to 90th $145 to $3,802Professionalmedian $257 · 10th to 90th $155 to $372
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 $199.53 Median $407.38 Typical High $7,079.46 | Facility | None | $199.53 | $407.38 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $281.84 Typical High $407.38 | Professional | None | $169.82 | $281.84 | $407.38 |
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 $158.49 Median $257.04 Typical High $354.81 | Professional | None | $158.49 | $257.04 | $354.81 |
CareFirst Setting Professional Modifier None Typical Low $134.90 Median $147.91 Typical High $177.83 | Professional | None | $134.90 | $147.91 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $208.93 Typical High $389.05 | Facility | None | $50.12 | $208.93 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $257.04 Typical High $371.54 | Professional | None | $169.82 | $257.04 | $371.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $257.04 Median $338.84 Typical High $407.38 | Professional | None | $257.04 | $338.84 | $407.38 |
Medcost Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $354.81 | Professional | None | $309.03 | $309.03 | $354.81 |
Medcost Setting Facility Modifier None Typical Low $190.55 Median $295.12 Typical High $478.63 | Facility | None | $190.55 | $295.12 | $478.63 |
Medcost Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,174.90 | $1,174.90 | $1,174.90 |
Sentara Setting Facility Modifier None Typical Low $147.91 Median $398.11 Typical High $2,454.71 | Facility | None | $147.91 | $398.11 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $194.98 Median $323.59 Typical High $1,230.27 | Professional | None | $194.98 | $323.59 | $1,230.27 |
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 $144.54 Median $245.47 Typical High $407.38 | Professional | None | $144.54 | $245.47 | $407.38 |
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 $102.33 Typical High $147.91 | Professional | 52 · Reduced service | $85.11 | $102.33 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $40.74 Typical High $60.26 | Professional | 53 · Discontinued | $34.67 | $40.74 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $151.36 Typical High $223.87 | Professional | 54 · Surgery only | $128.82 | $151.36 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $30.90 Typical High $44.67 | Professional | 55 · Aftercare only | $25.70 | $30.90 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $20.42 Typical High $29.51 | Professional | 56 · Pre-op care only | $16.98 | $20.42 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $141.25 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $120.23 | $141.25 | $208.93 |
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· 27th of 51
$269
AK $692KY $204
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.