How much rates vary
Facilitymedian $646 · 10th to 90th $85 to $4,365Professionalmedian $132 · 10th to 90th $83 to $195
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 $100.00 Median $4,073.80 Typical High $10,000.00 | Facility | None | $100.00 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $144.54 Typical High $218.78 | Professional | None | $87.10 | $144.54 | $218.78 |
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 $83.18 Median $125.89 Typical High $181.97 | Professional | None | $83.18 | $125.89 | $181.97 |
CareFirst Setting Professional Modifier None Typical Low $89.13 Median $97.72 Typical High $114.82 | Professional | None | $89.13 | $97.72 | $114.82 |
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 $85.11 Median $131.83 Typical High $194.98 | Professional | None | $85.11 | $131.83 | $194.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $131.83 Median $173.78 Typical High $204.17 | Professional | None | $131.83 | $173.78 | $204.17 |
Medcost Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $169.82 | Professional | None | $147.91 | $147.91 | $169.82 |
Medcost Setting Facility Modifier None Typical Low $100.00 Median $162.18 Typical High $263.03 | Facility | None | $100.00 | $162.18 | $263.03 |
Medcost Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
Sentara Setting Facility Modifier None Typical Low $75.86 Median $302.00 Typical High $2,454.71 | Facility | None | $75.86 | $302.00 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $100.00 Median $173.78 Typical High $1,071.52 | Professional | None | $100.00 | $173.78 | $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 $74.13 Median $125.89 Typical High $218.78 | Professional | None | $74.13 | $125.89 | $218.78 |
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 $43.65 Median $56.23 Typical High $81.28 | Professional | 52 · Reduced service | $43.65 | $56.23 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $22.91 Typical High $32.36 | Professional | 53 · Discontinued | $17.38 | $22.91 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $85.11 Typical High $120.23 | Professional | 54 · Surgery only | $66.07 | $85.11 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $16.98 Typical High $23.99 | Professional | 55 · Aftercare only | $13.18 | $16.98 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $11.48 Typical High $16.22 | Professional | 56 · Pre-op care only | $8.71 | $11.48 | $16.22 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $79.43 Typical High $112.20 | Professional | 78 · Unplanned return to OR | $61.66 | $79.43 | $112.20 |
Where Virginia sits
The same service costs 3.5 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· 30th of 51
$138
AK $389KY $110
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.