How much rates vary
Facilitymedian $501 · 10th to 90th $91 to $4,074Professionalmedian $132 · 10th to 90th $91 to $200
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 $112.20 Median $4,073.80 Typical High $10,000.00 | Facility | None | $112.20 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $144.54 Typical High $204.17 | Professional | None | $95.50 | $144.54 | $204.17 |
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 $89.13 Median $125.89 Typical High $194.98 | Professional | None | $89.13 | $125.89 | $194.98 |
CareFirst Setting Professional Modifier None Typical Low $97.72 Median $107.15 Typical High $125.89 | Professional | None | $97.72 | $107.15 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $102.33 Typical High $190.55 | Facility | None | $50.12 | $102.33 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $141.25 Typical High $199.53 | Professional | None | $93.33 | $141.25 | $199.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $134.90 Median $173.78 Typical High $208.93 | Professional | None | $134.90 | $173.78 | $208.93 |
Medcost Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $181.97 | Professional | None | $162.18 | $162.18 | $181.97 |
Medcost Setting Facility Modifier None Typical Low $112.20 Median $165.96 Typical High $269.15 | Facility | None | $112.20 | $165.96 | $269.15 |
Medcost Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
Sentara Setting Facility Modifier None Typical Low $81.28 Median $371.54 Typical High $2,454.71 | Facility | None | $81.28 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $104.71 Median $177.83 Typical High $933.25 | Professional | None | $104.71 | $177.83 | $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 $79.43 Median $131.83 Typical High $229.09 | Professional | None | $79.43 | $131.83 | $229.09 |
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 $47.86 Median $60.26 Typical High $83.18 | Professional | 52 · Reduced service | $47.86 | $60.26 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $23.99 Typical High $33.11 | Professional | 53 · Discontinued | $19.50 | $23.99 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $89.13 Typical High $123.03 | Professional | 54 · Surgery only | $72.44 | $89.13 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $17.78 Typical High $25.12 | Professional | 55 · Aftercare only | $14.45 | $17.78 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $12.02 Typical High $16.60 | Professional | 56 · Pre-op care only | $9.55 | $12.02 | $16.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $67.61 Median $83.18 Typical High $114.82 | Professional | 78 · Unplanned return to OR | $67.61 | $83.18 | $114.82 |
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· 33rd 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.