How much rates vary
Facilitymedian $1,413 · 10th to 90th $209 to $5,623Professionalmedian $186 · 10th to 90th $148 to $347
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 $218.78 Median $588.84 Typical High $8,317.64 | Facility | None | $218.78 | $588.84 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $263.03 Typical High $295.12 | Professional | None | $162.18 | $263.03 | $295.12 |
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 $147.91 Median $173.78 Typical High $213.80 | Professional | None | $147.91 | $173.78 | $213.80 |
CareFirst Setting Professional Modifier None Typical Low $154.88 Median $169.82 Typical High $223.87 | Professional | None | $154.88 | $169.82 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $831.76 Typical High $1,659.59 | Facility | None | $346.74 | $831.76 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $239.88 Typical High $371.54 | Professional | None | $151.36 | $239.88 | $371.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $263.03 Median $316.23 Typical High $407.38 | Professional | None | $263.03 | $316.23 | $407.38 |
Medcost Setting Professional Modifier None Typical Low $275.42 Median $346.74 Typical High $346.74 | Professional | None | $275.42 | $346.74 | $346.74 |
Medcost Setting Facility Modifier None Typical Low $177.83 Median $288.40 Typical High $478.63 | Facility | None | $177.83 | $288.40 | $478.63 |
Medcost Setting Professional Modifier None Typical Low $117.49 Median $158.49 Typical High $309.03 | Professional | None | $117.49 | $158.49 | $309.03 |
Sentara Setting Facility Modifier None Typical Low $141.25 Median $912.01 Typical High $3,630.78 | Facility | None | $141.25 | $912.01 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $165.96 Median $302.00 Typical High $630.96 | Professional | None | $165.96 | $302.00 | $630.96 |
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 $114.82 Median $208.93 Typical High $398.11 | Professional | None | $114.82 | $208.93 | $398.11 |
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 $81.28 Median $120.23 Typical High $144.54 | Professional | 52 · Reduced service | $81.28 | $120.23 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $47.86 Typical High $58.88 | Professional | 53 · Discontinued | $32.36 | $47.86 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $181.97 Typical High $218.78 | Professional | 54 · Surgery only | $123.03 | $181.97 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $36.31 Typical High $43.65 | Professional | 55 · Aftercare only | $24.55 | $36.31 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $23.99 Typical High $29.51 | Professional | 56 · Pre-op care only | $16.22 | $23.99 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $169.82 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $114.82 | $169.82 | $204.17 |
Where Virginia sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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· 50th of 51
$191
AK $759KY $170
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.