How much rates vary
Facilitymedian $501 · 10th to 90th $93 to $4,074Professionalmedian $151 · 10th to 90th $100 to $219
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 $123.03 Median $4,073.80 Typical High $10,000.00 | Facility | None | $123.03 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $158.49 Typical High $223.87 | Professional | None | $107.15 | $158.49 | $223.87 |
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 $100.00 Median $141.25 Typical High $204.17 | Professional | None | $100.00 | $141.25 | $204.17 |
CareFirst Setting Professional Modifier None Typical Low $107.15 Median $117.49 Typical High $138.04 | Professional | None | $107.15 | $117.49 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $112.20 Typical High $208.93 | Facility | None | $50.12 | $112.20 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $158.49 Typical High $218.78 | Professional | None | $100.00 | $158.49 | $218.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $147.91 Median $194.98 Typical High $229.09 | Professional | None | $147.91 | $194.98 | $229.09 |
Medcost Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $199.53 | Professional | None | $173.78 | $173.78 | $199.53 |
Medcost Setting Facility Modifier None Typical Low $123.03 Median $181.97 Typical High $295.12 | Facility | None | $123.03 | $181.97 | $295.12 |
Medcost Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
Sentara Setting Facility Modifier None Typical Low $93.33 Median $371.54 Typical High $2,454.71 | Facility | None | $93.33 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $114.82 Median $199.53 Typical High $1,071.52 | Professional | None | $114.82 | $199.53 | $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 $89.13 Median $147.91 Typical High $251.19 | Professional | None | $89.13 | $147.91 | $251.19 |
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 $52.48 Median $64.57 Typical High $91.20 | Professional | 52 · Reduced service | $52.48 | $64.57 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $25.70 Typical High $36.31 | Professional | 53 · Discontinued | $21.38 | $25.70 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $97.72 Typical High $138.04 | Professional | 54 · Surgery only | $79.43 | $97.72 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $19.50 Typical High $27.54 | Professional | 55 · Aftercare only | $15.85 | $19.50 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $12.88 Typical High $18.20 | Professional | 56 · Pre-op care only | $10.72 | $12.88 | $18.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $91.20 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $74.13 | $91.20 | $128.82 |
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· 29th of 51
$155
AK $427KY $123
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.