How much rates vary
Facilitymedian $646 · 10th to 90th $85 to $4,365Professionalmedian $126 · 10th to 90th $83 to $186
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 $131.83 Typical High $190.55 | Professional | None | $87.10 | $131.83 | $190.55 |
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 $120.23 Typical High $173.78 | Professional | None | $83.18 | $120.23 | $173.78 |
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 $190.55 | Professional | None | $85.11 | $131.83 | $190.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $125.89 Median $165.96 Typical High $194.98 | Professional | None | $125.89 | $165.96 | $194.98 |
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 $154.88 Typical High $251.19 | Facility | None | $100.00 | $154.88 | $251.19 |
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 $74.13 Median $302.00 Typical High $2,454.71 | Facility | None | $74.13 | $302.00 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $97.72 Median $169.82 Typical High $1,071.52 | Professional | None | $97.72 | $169.82 | $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 $72.44 Median $123.03 Typical High $213.80 | Professional | None | $72.44 | $123.03 | $213.80 |
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 $54.95 Typical High $77.62 | Professional | 52 · Reduced service | $43.65 | $54.95 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $21.88 Typical High $30.90 | Professional | 53 · Discontinued | $17.38 | $21.88 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $81.28 Typical High $117.49 | Professional | 54 · Surgery only | $64.57 | $81.28 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $16.22 Typical High $23.44 | Professional | 55 · Aftercare only | $13.18 | $16.22 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $10.96 Typical High $15.49 | Professional | 56 · Pre-op care only | $8.71 | $10.96 | $15.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $60.26 Median $75.86 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $60.26 | $75.86 | $109.65 |
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· 35th of 51
$132
AK $355KY $100
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.