How much rates vary
Facilitymedian $1,175 · 10th to 90th $174 to $4,898Professionalmedian $204 · 10th to 90th $141 to $295
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 $229.09 Median $3,801.89 Typical High $9,332.54 | Facility | None | $229.09 | $3,801.89 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $229.09 Typical High $323.59 | Professional | None | $154.88 | $229.09 | $323.59 |
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 $144.54 Median $204.17 Typical High $281.84 | Professional | None | $144.54 | $204.17 | $281.84 |
CareFirst Setting Professional Modifier None Typical Low $154.88 Median $173.78 Typical High $204.17 | Professional | None | $154.88 | $173.78 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $323.59 Typical High $1,621.81 | Facility | None | $162.18 | $323.59 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $204.17 Typical High $309.03 | Professional | None | $144.54 | $204.17 | $309.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $223.87 Median $269.15 Typical High $338.84 | Professional | None | $223.87 | $269.15 | $338.84 |
Medcost Setting Professional Modifier None Typical Low $223.87 Median $302.00 Typical High $302.00 | Professional | None | $223.87 | $302.00 | $302.00 |
Medcost Setting Facility Modifier None Typical Low $165.96 Median $229.09 Typical High $371.54 | Facility | None | $165.96 | $229.09 | $371.54 |
Medcost Setting Professional Modifier None Typical Low $87.10 Median $104.71 Typical High $229.09 | Professional | None | $87.10 | $104.71 | $229.09 |
Sentara Setting Facility Modifier None Typical Low $138.04 Median $616.60 Typical High $2,951.21 | Facility | None | $138.04 | $616.60 | $2,951.21 |
Sentara Setting Professional Modifier None Typical Low $204.17 Median $245.47 Typical High $512.86 | Professional | None | $204.17 | $245.47 | $512.86 |
United Setting Facility Modifier None Typical Low $323.59 Median $1,445.44 Typical High $3,630.78 | Facility | None | $323.59 | $1,445.44 | $3,630.78 |
United Setting Professional Modifier None Typical Low $109.65 Median $173.78 Typical High $331.13 | Professional | None | $109.65 | $173.78 | $331.13 |
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 $77.62 Median $102.33 Typical High $114.82 | Professional | 52 · Reduced service | $77.62 | $102.33 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $41.69 Typical High $46.77 | Professional | 53 · Discontinued | $30.90 | $41.69 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $154.88 Typical High $173.78 | Professional | 54 · Surgery only | $114.82 | $154.88 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $30.90 Typical High $34.67 | Professional | 55 · Aftercare only | $22.91 | $30.90 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $20.42 Typical High $23.44 | Professional | 56 · Pre-op care only | $15.49 | $20.42 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $144.54 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $107.15 | $144.54 | $162.18 |
Where Virginia sits
The same service costs 3.5 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· 35th of 51
$209
AK $603FL $174
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.