How much rates vary
Facilitymedian $457 · 10th to 90th $138 to $3,802Professionalmedian $234 · 10th to 90th $182 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 $234.42 Median $2,041.74 Typical High $8,317.64 | Facility | None | $234.42 | $2,041.74 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $245.47 Typical High $398.11 | Professional | None | $218.78 | $245.47 | $398.11 |
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 $199.53 Median $239.88 Typical High $288.40 | Professional | None | $199.53 | $239.88 | $288.40 |
CareFirst Setting Professional Modifier None Typical Low $223.87 Median $251.19 Typical High $295.12 | Professional | None | $223.87 | $251.19 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $141.25 Typical High $263.03 | Facility | None | $50.12 | $141.25 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $229.09 Typical High $338.84 | Professional | None | $194.98 | $229.09 | $338.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $229.09 Median $275.42 Typical High $354.81 | Professional | None | $229.09 | $275.42 | $354.81 |
Medcost Setting Professional Modifier None Typical Low $263.03 Median $331.13 Typical High $346.74 | Professional | None | $263.03 | $331.13 | $346.74 |
Medcost Setting Facility Modifier None Typical Low $229.09 Median $245.47 Typical High $398.11 | Facility | None | $229.09 | $245.47 | $398.11 |
Medcost Setting Professional Modifier None Typical Low $186.21 Median $223.87 Typical High $245.47 | Professional | None | $186.21 | $223.87 | $245.47 |
Sentara Setting Facility Modifier None Typical Low $169.82 Median $389.05 Typical High $2,454.71 | Facility | None | $169.82 | $389.05 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $204.17 Median $257.04 Typical High $524.81 | Professional | None | $204.17 | $257.04 | $524.81 |
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 $144.54 Median $199.53 Typical High $389.05 | Professional | None | $144.54 | $199.53 | $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 $109.65 Median $114.82 Typical High $123.03 | Professional | 52 · Reduced service | $109.65 | $114.82 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $45.71 Typical High $48.98 | Professional | 53 · Discontinued | $44.67 | $45.71 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $169.82 Typical High $181.97 | Professional | 54 · Surgery only | $165.96 | $169.82 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $33.88 Typical High $37.15 | Professional | 55 · Aftercare only | $33.11 | $33.88 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $22.91 Typical High $24.55 | Professional | 56 · Pre-op care only | $21.88 | $22.91 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $158.49 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $154.88 | $158.49 | $169.82 |
Where Virginia sits
The same service costs 5.1 times more in Alaska than in Utah. 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
$234
AK $871UT $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.