How much rates vary
Facilitymedian $398 · 10th to 90th $69 to $3,802Professionalmedian $102 · 10th to 90th $66 to $151
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 $95.50 Median $165.96 Typical High $8,317.64 | Facility | None | $95.50 | $165.96 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $112.20 Typical High $173.78 | Professional | None | $69.18 | $112.20 | $173.78 |
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 $66.07 Median $95.50 Typical High $138.04 | Professional | None | $66.07 | $95.50 | $138.04 |
CareFirst Setting Professional Modifier None Typical Low $70.79 Median $79.43 Typical High $93.33 | Professional | None | $70.79 | $79.43 | $93.33 |
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 $67.61 Median $102.33 Typical High $147.91 | Professional | None | $67.61 | $102.33 | $147.91 |
Kaiser Permanente Setting Professional Modifier None Typical Low $102.33 Median $134.90 Typical High $158.49 | Professional | None | $102.33 | $134.90 | $158.49 |
Medcost Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $134.90 | Professional | None | $123.03 | $123.03 | $134.90 |
Medcost Setting Facility Modifier None Typical Low $75.86 Median $123.03 Typical High $199.53 | Facility | None | $75.86 | $123.03 | $199.53 |
Medcost Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
Sentara Setting Facility Modifier None Typical Low $50.12 Median $288.40 Typical High $2,454.71 | Facility | None | $50.12 | $288.40 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $70.79 Median $131.83 Typical High $933.25 | Professional | None | $70.79 | $131.83 | $933.25 |
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 $56.23 Median $97.72 Typical High $169.82 | Professional | None | $56.23 | $97.72 | $169.82 |
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 $34.67 Median $43.65 Typical High $61.66 | Professional | 52 · Reduced service | $34.67 | $43.65 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $17.38 Typical High $24.55 | Professional | 53 · Discontinued | $13.80 | $17.38 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $64.57 Typical High $91.20 | Professional | 54 · Surgery only | $51.29 | $64.57 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $13.18 Typical High $18.20 | Professional | 55 · Aftercare only | $10.47 | $13.18 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $8.71 Typical High $12.30 | Professional | 56 · Pre-op care only | $6.92 | $8.71 | $12.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $47.86 Median $60.26 Typical High $85.11 | Professional | 78 · Unplanned return to OR | $47.86 | $60.26 | $85.11 |
Where Virginia sits
The same service costs 3.9 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
$107
AK $309KY $79.43
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.