How much rates vary
Facilitymedian $661 · 10th to 90th $148 to $3,981Professionalmedian $224 · 10th to 90th $158 to $324
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 $199.53 Median $4,073.80 Typical High $10,000.00 | Facility | None | $199.53 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $223.87 Typical High $323.59 | Professional | None | $165.96 | $223.87 | $323.59 |
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 $158.49 Median $223.87 Typical High $309.03 | Professional | None | $158.49 | $223.87 | $309.03 |
CareFirst Setting Professional Modifier None Typical Low $165.96 Median $186.21 Typical High $218.78 | Professional | None | $165.96 | $186.21 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $323.59 Typical High $1,621.81 | Facility | None | $147.91 | $323.59 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $234.42 Typical High $331.13 | Professional | None | $158.49 | $234.42 | $331.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $218.78 Median $281.84 Typical High $338.84 | Professional | None | $218.78 | $281.84 | $338.84 |
Medcost Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $316.23 | Professional | None | $275.42 | $275.42 | $316.23 |
Medcost Setting Facility Modifier None Typical Low $199.53 Median $275.42 Typical High $446.68 | Facility | None | $199.53 | $275.42 | $446.68 |
Medcost Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
Sentara Setting Facility Modifier None Typical Low $151.36 Median $389.05 Typical High $2,454.71 | Facility | None | $151.36 | $389.05 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $173.78 Median $295.12 Typical High $1,174.90 | Professional | None | $173.78 | $295.12 | $1,174.90 |
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 $141.25 Median $218.78 Typical High $389.05 | Professional | None | $141.25 | $218.78 | $389.05 |
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 $83.18 Median $100.00 Typical High $138.04 | Professional | 52 · Reduced service | $83.18 | $100.00 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $39.81 Typical High $54.95 | Professional | 53 · Discontinued | $33.88 | $39.81 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $147.91 Typical High $204.17 | Professional | 54 · Surgery only | $125.89 | $147.91 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $30.20 Typical High $40.74 | Professional | 55 · Aftercare only | $25.12 | $30.20 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $19.95 Typical High $27.54 | Professional | 56 · Pre-op care only | $16.60 | $19.95 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $138.04 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $117.49 | $138.04 | $190.55 |
Where Virginia sits
The same service costs 3.5 times more in Alaska than in Texas. 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· 34th of 51
$229
AK $676TX $191
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.