How much rates vary
Facilitymedian $513 · 10th to 90th $105 to $3,802Professionalmedian $204 · 10th to 90th $129 to $302
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 $154.88 Median $4,365.16 Typical High $14,125.38 | Facility | None | $154.88 | $4,365.16 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $194.98 Typical High $275.42 | Professional | None | $134.90 | $194.98 | $275.42 |
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 $125.89 Median $199.53 Typical High $281.84 | Professional | None | $125.89 | $199.53 | $281.84 |
CareFirst Setting Professional Modifier None Typical Low $134.90 Median $151.36 Typical High $177.83 | Professional | None | $134.90 | $151.36 | $177.83 |
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 $128.82 Median $204.17 Typical High $323.59 | Professional | None | $128.82 | $204.17 | $323.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $213.80 Median $275.42 Typical High $331.13 | Professional | None | $213.80 | $275.42 | $331.13 |
Medcost Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $323.59 | Professional | None | $199.53 | $199.53 | $323.59 |
Medcost Setting Facility Modifier None Typical Low $154.88 Median $251.19 Typical High $446.68 | Facility | None | $154.88 | $251.19 | $446.68 |
Medcost Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
Sentara Setting Facility Modifier None Typical Low $125.89 Median $346.74 Typical High $2,454.71 | Facility | None | $125.89 | $346.74 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $154.88 Median $288.40 Typical High $1,174.90 | Professional | None | $154.88 | $288.40 | $1,174.90 |
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 $117.49 Median $204.17 Typical High $371.54 | Professional | None | $117.49 | $204.17 | $371.54 |
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 $67.61 Median $91.20 Typical High $138.04 | Professional | 52 · Reduced service | $67.61 | $91.20 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $37.15 Typical High $54.95 | Professional | 53 · Discontinued | $26.92 | $37.15 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $138.04 Typical High $204.17 | Professional | 54 · Surgery only | $102.33 | $138.04 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $27.54 Typical High $40.74 | Professional | 55 · Aftercare only | $20.42 | $27.54 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $18.62 Typical High $27.54 | Professional | 56 · Pre-op care only | $13.49 | $18.62 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $128.82 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $95.50 | $128.82 | $190.55 |
Where Virginia sits
The same service costs 3.8 times more in Alaska than in Maryland. 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
$214
AK $603MD $158
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.