How much rates vary
Facilitymedian $501 · 10th to 90th $100 to $4,074Professionalmedian $135 · 10th to 90th $105 to $204
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 $134.90 Median $3,981.07 Typical High $9,332.54 | Facility | None | $134.90 | $3,981.07 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $138.04 Typical High $218.78 | Professional | None | $128.82 | $138.04 | $218.78 |
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 $117.49 Median $141.25 Typical High $169.82 | Professional | None | $117.49 | $141.25 | $169.82 |
CareFirst Setting Professional Modifier None Typical Low $134.90 Median $147.91 Typical High $173.78 | Professional | None | $134.90 | $147.91 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $91.20 Typical High $173.78 | Facility | None | $50.12 | $91.20 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $131.83 Typical High $223.87 | Professional | None | $114.82 | $131.83 | $223.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $154.88 Typical High $194.98 | Professional | None | $128.82 | $154.88 | $194.98 |
Medcost Setting Professional Modifier None Typical Low $134.90 Median $169.82 Typical High $181.97 | Professional | None | $134.90 | $169.82 | $181.97 |
Medcost Setting Facility Modifier None Typical Low $134.90 Median $144.54 Typical High $223.87 | Facility | None | $134.90 | $144.54 | $223.87 |
Medcost Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $141.25 | Professional | None | $107.15 | $107.15 | $141.25 |
Sentara Setting Facility Modifier None Typical Low $100.00 Median $371.54 Typical High $2,454.71 | Facility | None | $100.00 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $109.65 Median $141.25 Typical High $295.12 | Professional | None | $109.65 | $141.25 | $295.12 |
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 $81.28 Median $109.65 Typical High $218.78 | Professional | None | $81.28 | $109.65 | $218.78 |
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 $64.57 Median $67.61 Typical High $69.18 | Professional | 52 · Reduced service | $64.57 | $67.61 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $26.92 Typical High $27.54 | Professional | 53 · Discontinued | $25.70 | $26.92 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $100.00 Typical High $102.33 | Professional | 54 · Surgery only | $97.72 | $100.00 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $19.95 Typical High $20.42 | Professional | 55 · Aftercare only | $19.50 | $19.95 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $13.49 Typical High $13.80 | Professional | 56 · Pre-op care only | $12.88 | $13.49 | $13.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $93.33 Typical High $95.50 | Professional | 78 · Unplanned return to OR | $91.20 | $93.33 | $95.50 |
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
$138
AK $501UT $97.72
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.