How much rates vary
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 $53.70 Median $4,365.16 Typical High $14,125.38 | Facility | None | $53.70 | $4,365.16 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $53.70 Typical High $63.10 | Professional | None | $45.71 | $53.70 | $63.10 |
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 $44.67 Median $56.23 Typical High $69.18 | Professional | None | $44.67 | $56.23 | $69.18 |
CareFirst Setting Professional Modifier None Typical Low $48.98 Median $54.95 Typical High $64.57 | Professional | None | $48.98 | $54.95 | $64.57 |
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 $46.77 Median $51.29 Typical High $74.13 | Professional | None | $46.77 | $51.29 | $74.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $46.77 Median $61.66 Typical High $74.13 | Professional | None | $46.77 | $61.66 | $74.13 |
Medcost Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $74.13 | Professional | None | $61.66 | $61.66 | $74.13 |
Medcost Setting Facility Modifier None Typical Low $54.95 Median $61.66 Typical High $95.50 | Facility | None | $54.95 | $61.66 | $95.50 |
Medcost Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
Sentara Setting Facility Modifier None Typical Low $42.66 Median $181.97 Typical High $2,454.71 | Facility | None | $42.66 | $181.97 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $37.15 Median $63.10 Typical High $1,071.52 | Professional | None | $37.15 | $63.10 | $1,071.52 |
United Setting Facility Modifier None Typical Low $100.00 Median $645.65 Typical High $2,041.74 | Facility | None | $100.00 | $645.65 | $2,041.74 |
United Setting Professional Modifier None Typical Low $37.15 Median $51.29 Typical High $89.13 | Professional | None | $37.15 | $51.29 | $89.13 |
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 $22.91 Median $26.92 Typical High $29.51 | Professional | 52 · Reduced service | $22.91 | $26.92 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $10.72 Typical High $11.75 | Professional | 53 · Discontinued | $9.33 | $10.72 | $11.75 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $39.81 Typical High $43.65 | Professional | 54 · Surgery only | $34.67 | $39.81 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $7.94 Typical High $8.71 | Professional | 55 · Aftercare only | $6.92 | $7.94 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $5.37 Typical High $5.89 | Professional | 56 · Pre-op care only | $4.68 | $5.37 | $5.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $32.36 Median $37.15 Typical High $40.74 | Professional | 78 · Unplanned return to OR | $32.36 | $37.15 | $40.74 |
Where Virginia sits
The same service costs 4.6 times more in Alaska than in New York. 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
$54.95
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.