How much rates vary
Facilitymedian $617 · 10th to 90th $71 to $4,365Professionalmedian $93 · 10th to 90th $68 to $132
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 $79.43 Median $4,073.80 Typical High $10,000.00 | Facility | None | $79.43 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $97.72 Typical High $144.54 | Professional | None | $69.18 | $97.72 | $144.54 |
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 $67.61 Median $93.33 Typical High $128.82 | Professional | None | $67.61 | $93.33 | $128.82 |
CareFirst Setting Professional Modifier None Typical Low $72.44 Median $79.43 Typical High $93.33 | Professional | None | $72.44 | $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 $97.72 Typical High $131.83 | Professional | None | $67.61 | $97.72 | $131.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $87.10 Median $114.82 Typical High $138.04 | Professional | None | $87.10 | $114.82 | $138.04 |
Medcost Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $131.83 | Professional | None | $117.49 | $117.49 | $131.83 |
Medcost Setting Facility Modifier None Typical Low $79.43 Median $107.15 Typical High $173.78 | Facility | None | $79.43 | $107.15 | $173.78 |
Medcost Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
Sentara Setting Facility Modifier None Typical Low $58.88 Median $288.40 Typical High $2,454.71 | Facility | None | $58.88 | $288.40 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $69.18 Median $114.82 Typical High $1,071.52 | Professional | None | $69.18 | $114.82 | $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 $57.54 Median $89.13 Typical High $154.88 | Professional | None | $57.54 | $89.13 | $154.88 |
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 $35.48 Median $40.74 Typical High $52.48 | Professional | 52 · Reduced service | $35.48 | $40.74 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $16.22 Typical High $21.38 | Professional | 53 · Discontinued | $14.45 | $16.22 | $21.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $60.26 Typical High $79.43 | Professional | 54 · Surgery only | $53.70 | $60.26 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $12.30 Typical High $15.85 | Professional | 55 · Aftercare only | $10.72 | $12.30 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $8.13 Typical High $10.72 | Professional | 56 · Pre-op care only | $7.08 | $8.13 | $10.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $50.12 Median $56.23 Typical High $74.13 | Professional | 78 · Unplanned return to OR | $50.12 | $56.23 | $74.13 |
Where Virginia sits
The same service costs 3.8 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· 36th of 51
$95.50
AK $288KY $75.86
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.