How much rates vary
Facilitymedian $1,230 · 10th to 90th $182 to $4,786Professionalmedian $182 · 10th to 90th $145 to $339
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 $177.83 Median $4,073.80 Typical High $10,000.00 | Facility | None | $177.83 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $251.19 Typical High $288.40 | Professional | None | $162.18 | $251.19 | $288.40 |
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 $173.78 Typical High $208.93 | Professional | None | $144.54 | $173.78 | $208.93 |
CareFirst Setting Professional Modifier None Typical Low $154.88 Median $169.82 Typical High $204.17 | Professional | None | $154.88 | $169.82 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $354.81 Typical High $1,621.81 | Facility | None | $190.55 | $354.81 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $245.47 Typical High $371.54 | Professional | None | $151.36 | $245.47 | $371.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $257.04 Median $309.03 Typical High $389.05 | Professional | None | $257.04 | $309.03 | $389.05 |
Medcost Setting Professional Modifier None Typical Low $263.03 Median $323.59 Typical High $323.59 | Professional | None | $263.03 | $323.59 | $323.59 |
Medcost Setting Facility Modifier None Typical Low $177.83 Median $288.40 Typical High $467.74 | Facility | None | $177.83 | $288.40 | $467.74 |
Medcost Setting Professional Modifier None Typical Low $125.89 Median $162.18 Typical High $309.03 | Professional | None | $125.89 | $162.18 | $309.03 |
Sentara Setting Facility Modifier None Typical Low $134.90 Median $616.60 Typical High $2,951.21 | Facility | None | $134.90 | $616.60 | $2,951.21 |
Sentara Setting Professional Modifier None Typical Low $165.96 Median $295.12 Typical High $616.60 | Professional | None | $165.96 | $295.12 | $616.60 |
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 $114.82 Median $204.17 Typical High $389.05 | Professional | None | $114.82 | $204.17 | $389.05 |
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 $141.25 | Professional | 52 · Reduced service | $81.28 | $120.23 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $47.86 Typical High $57.54 | Professional | 53 · Discontinued | $32.36 | $47.86 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $181.97 Typical High $213.80 | Professional | 54 · Surgery only | $120.23 | $181.97 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $36.31 Typical High $42.66 | Professional | 55 · Aftercare only | $23.99 | $36.31 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $23.99 Typical High $28.84 | Professional | 56 · Pre-op care only | $16.22 | $23.99 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $169.82 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $112.20 | $169.82 | $199.53 |
Where Virginia sits
The same service costs 4.4 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 $661KY $151
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.