How much rates vary
Facilitymedian $1,738 · 10th to 90th $95 to $5,754Professionalmedian $117 · 10th to 90th $83 to $170
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 $95.50 Median $4,073.80 Typical High $10,000.00 | Facility | None | $95.50 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $120.23 Typical High $131.83 | Professional | None | $93.33 | $120.23 | $131.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $3,715.35 Typical High $4,265.80 | Facility | None | $2,884.03 | $3,715.35 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $87.10 Median $117.49 Typical High $162.18 | Professional | None | $87.10 | $117.49 | $162.18 |
CareFirst Setting Professional Modifier None Typical Low $87.10 Median $95.50 Typical High $125.89 | Professional | None | $87.10 | $95.50 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $85.11 Typical High $158.49 | Facility | None | $50.12 | $85.11 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $123.03 Typical High $186.21 | Professional | None | $89.13 | $123.03 | $186.21 |
Kaiser Permanente Setting Professional Modifier None Typical Low $125.89 Median $151.36 Typical High $190.55 | Professional | None | $125.89 | $151.36 | $190.55 |
Medcost Setting Professional Modifier None Typical Low $173.78 Median $213.80 Typical High $380.19 | Professional | None | $173.78 | $213.80 | $380.19 |
Medcost Setting Facility Modifier None Typical Low $95.50 Median $125.89 Typical High $199.53 | Facility | None | $95.50 | $125.89 | $199.53 |
Medcost Setting Professional Modifier None Typical Low $43.65 Median $52.48 Typical High $138.04 | Professional | None | $43.65 | $52.48 | $138.04 |
Sentara Setting Facility Modifier None Typical Low $89.13 Median $891.25 Typical High $3,630.78 | Facility | None | $89.13 | $891.25 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $117.49 Median $158.49 Typical High $309.03 | Professional | None | $117.49 | $158.49 | $309.03 |
United Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $5,888.44 | Facility | None | $588.84 | $2,187.76 | $5,888.44 |
United Setting Professional Modifier None Typical Low $66.07 Median $102.33 Typical High $199.53 | Professional | None | $66.07 | $102.33 | $199.53 |
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 $45.71 Median $58.88 Typical High $66.07 | Professional | 52 · Reduced service | $45.71 | $58.88 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $23.44 Typical High $26.30 | Professional | 53 · Discontinued | $18.62 | $23.44 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $87.10 Typical High $97.72 | Professional | 54 · Surgery only | $69.18 | $87.10 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $17.38 Typical High $19.95 | Professional | 55 · Aftercare only | $13.80 | $17.38 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $11.75 Typical High $13.18 | Professional | 56 · Pre-op care only | $9.33 | $11.75 | $13.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $81.28 Typical High $91.20 | Professional | 78 · Unplanned return to OR | $64.57 | $81.28 | $91.20 |
Where Virginia sits
The same service costs 4.0 times more in Alaska than in Florida. 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· 37th of 51
$120
AK $363FL $91.20
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.