How much rates vary
Facilitymedian $537 · 10th to 90th $105 to $4,074Professionalmedian $186 · 10th to 90th $129 to $275
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 $162.18 Median $4,073.80 Typical High $10,000.00 | Facility | None | $162.18 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $194.98 Typical High $281.84 | Professional | None | $134.90 | $194.98 | $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 $125.89 Median $181.97 Typical High $263.03 | Professional | None | $125.89 | $181.97 | $263.03 |
CareFirst Setting Professional Modifier None Typical Low $138.04 Median $151.36 Typical High $177.83 | Professional | None | $138.04 | $151.36 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $114.82 Typical High $213.80 | Facility | None | $50.12 | $114.82 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $199.53 Typical High $275.42 | Professional | None | $128.82 | $199.53 | $275.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $181.97 Median $239.88 Typical High $281.84 | Professional | None | $181.97 | $239.88 | $281.84 |
Medcost Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $257.04 | Professional | None | $223.87 | $223.87 | $257.04 |
Medcost Setting Facility Modifier None Typical Low $162.18 Median $229.09 Typical High $371.54 | Facility | None | $162.18 | $229.09 | $371.54 |
Medcost Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
Sentara Setting Facility Modifier None Typical Low $123.03 Median $371.54 Typical High $2,454.71 | Facility | None | $123.03 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $144.54 Median $245.47 Typical High $1,071.52 | Professional | None | $144.54 | $245.47 | $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 $117.49 Median $181.97 Typical High $323.59 | Professional | None | $117.49 | $181.97 | $323.59 |
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 $69.18 Median $81.28 Typical High $114.82 | Professional | 52 · Reduced service | $69.18 | $81.28 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $32.36 Typical High $45.71 | Professional | 53 · Discontinued | $27.54 | $32.36 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $123.03 Typical High $169.82 | Professional | 54 · Surgery only | $102.33 | $123.03 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $24.55 Typical High $34.67 | Professional | 55 · Aftercare only | $20.42 | $24.55 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $16.22 Typical High $22.91 | Professional | 56 · Pre-op care only | $13.80 | $16.22 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $114.82 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $95.50 | $114.82 | $158.49 |
Where Virginia sits
The same service costs 3.5 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· 33rd of 51
$195
AK $550MD $155
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.