How much rates vary
Facilitymedian $646 · 10th to 90th $100 to $4,365Professionalmedian $178 · 10th to 90th $117 to $257
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 $144.54 Median $4,073.80 Typical High $10,000.00 | Facility | None | $144.54 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $190.55 Typical High $281.84 | Professional | None | $123.03 | $190.55 | $281.84 |
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 $117.49 Median $165.96 Typical High $239.88 | Professional | None | $117.49 | $165.96 | $239.88 |
CareFirst Setting Professional Modifier None Typical Low $123.03 Median $138.04 Typical High $162.18 | Professional | None | $123.03 | $138.04 | $162.18 |
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 $117.49 Median $181.97 Typical High $257.04 | Professional | None | $117.49 | $181.97 | $257.04 |
Kaiser Permanente Setting Professional Modifier None Typical Low $169.82 Median $223.87 Typical High $269.15 | Professional | None | $169.82 | $223.87 | $269.15 |
Medcost Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $234.42 | Professional | None | $208.93 | $208.93 | $234.42 |
Medcost Setting Facility Modifier None Typical Low $144.54 Median $213.80 Typical High $346.74 | Facility | None | $144.54 | $213.80 | $346.74 |
Medcost Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
Sentara Setting Facility Modifier None Typical Low $107.15 Median $323.59 Typical High $2,454.71 | Facility | None | $107.15 | $323.59 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $134.90 Median $229.09 Typical High $1,071.52 | Professional | None | $134.90 | $229.09 | $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 $102.33 Median $173.78 Typical High $295.12 | Professional | None | $102.33 | $173.78 | $295.12 |
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 $61.66 Median $75.86 Typical High $107.15 | Professional | 52 · Reduced service | $61.66 | $75.86 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $30.20 Typical High $42.66 | Professional | 53 · Discontinued | $24.55 | $30.20 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $112.20 Typical High $162.18 | Professional | 54 · Surgery only | $91.20 | $112.20 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $22.91 Typical High $32.36 | Professional | 55 · Aftercare only | $18.20 | $22.91 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $15.14 Typical High $21.38 | Professional | 56 · Pre-op care only | $12.30 | $15.14 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $104.71 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $85.11 | $104.71 | $151.36 |
Where Virginia sits
The same service costs 3.3 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· 31st of 51
$182
AK $490MD $148
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.