How much rates vary
Facilitymedian $501 · 10th to 90th $87 to $3,802Professionalmedian $117 · 10th to 90th $89 to $166
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 $109.65 Median $4,365.16 Typical High $14,125.38 | Facility | None | $109.65 | $4,365.16 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $109.65 Typical High $141.25 | Professional | None | $93.33 | $109.65 | $141.25 |
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 $89.13 Median $114.82 Typical High $158.49 | Professional | None | $89.13 | $114.82 | $158.49 |
CareFirst Setting Professional Modifier None Typical Low $93.33 Median $104.71 Typical High $123.03 | Professional | None | $93.33 | $104.71 | $123.03 |
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 $89.13 Median $117.49 Typical High $177.83 | Professional | None | $89.13 | $117.49 | $177.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $109.65 Median $144.54 Typical High $169.82 | Professional | None | $109.65 | $144.54 | $169.82 |
Medcost Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $177.83 | Professional | None | $154.88 | $154.88 | $177.83 |
Medcost Setting Facility Modifier None Typical Low $109.65 Median $141.25 Typical High $229.09 | Facility | None | $109.65 | $141.25 | $229.09 |
Medcost Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
Sentara Setting Facility Modifier None Typical Low $83.18 Median $302.00 Typical High $2,454.71 | Facility | None | $83.18 | $302.00 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $91.20 Median $151.36 Typical High $1,071.52 | Professional | None | $91.20 | $151.36 | $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 $81.28 Median $117.49 Typical High $208.93 | Professional | None | $81.28 | $117.49 | $208.93 |
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 $46.77 Median $53.70 Typical High $70.79 | Professional | 52 · Reduced service | $46.77 | $53.70 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $21.88 Typical High $28.18 | Professional | 53 · Discontinued | $18.62 | $21.88 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $81.28 Typical High $107.15 | Professional | 54 · Surgery only | $70.79 | $81.28 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $16.22 Typical High $21.38 | Professional | 55 · Aftercare only | $14.13 | $16.22 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $10.96 Typical High $14.13 | Professional | 56 · Pre-op care only | $9.33 | $10.96 | $14.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $66.07 Median $75.86 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $66.07 | $75.86 | $100.00 |
Where Virginia sits
The same service costs 3.8 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· 36th of 51
$120
AK $380NY $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.