How much rates vary
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 $69.18 Median $123.03 Typical High $8,317.64 | Facility | None | $69.18 | $123.03 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $70.79 Typical High $120.23 | Professional | None | $56.23 | $70.79 | $120.23 |
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 $51.29 Median $66.07 Typical High $89.13 | Professional | None | $51.29 | $66.07 | $89.13 |
CareFirst Setting Professional Modifier None Typical Low $56.23 Median $63.10 Typical High $74.13 | Professional | None | $56.23 | $63.10 | $74.13 |
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 $53.70 Median $66.07 Typical High $102.33 | Professional | None | $53.70 | $66.07 | $102.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $60.26 Median $79.43 Typical High $95.50 | Professional | None | $60.26 | $79.43 | $95.50 |
Medcost Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $95.50 | Professional | None | $85.11 | $85.11 | $95.50 |
Medcost Setting Facility Modifier None Typical Low $60.26 Median $72.44 Typical High $117.49 | Facility | None | $60.26 | $72.44 | $117.49 |
Medcost Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
Sentara Setting Facility Modifier None Typical Low $42.66 Median $281.84 Typical High $2,454.71 | Facility | None | $42.66 | $281.84 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $48.98 Median $87.10 Typical High $1,071.52 | Professional | None | $48.98 | $87.10 | $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 $44.67 Median $63.10 Typical High $109.65 | Professional | None | $44.67 | $63.10 | $109.65 |
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 $28.18 Median $30.20 Typical High $36.31 | Professional | 52 · Reduced service | $28.18 | $30.20 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $12.02 Typical High $14.45 | Professional | 53 · Discontinued | $11.22 | $12.02 | $14.45 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $44.67 Typical High $53.70 | Professional | 54 · Surgery only | $41.69 | $44.67 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.91 Typical High $10.96 | Professional | 55 · Aftercare only | $8.32 | $8.91 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $6.03 Typical High $7.24 | Professional | 56 · Pre-op care only | $5.62 | $6.03 | $7.24 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $38.90 Median $41.69 Typical High $50.12 | Professional | 78 · Unplanned return to OR | $38.90 | $41.69 | $50.12 |
Where Virginia sits
The same service costs 4.2 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· 31st of 51
$69.18
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.