How much rates vary
Facilitymedian $575 · 10th to 90th $110 to $4,074Professionalmedian $158 · 10th to 90th $117 to $380
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 $257.04 Median $3,801.89 Typical High $9,332.54 | Facility | None | $257.04 | $3,801.89 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $269.15 Typical High $426.58 | Professional | None | $131.83 | $269.15 | $426.58 |
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 $114.82 Median $138.04 Typical High $177.83 | Professional | None | $114.82 | $138.04 | $177.83 |
CareFirst Setting Professional Modifier None Typical Low $123.03 Median $138.04 Typical High $2,238.72 | Professional | None | $123.03 | $138.04 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $223.87 Typical High $416.87 | Facility | None | $50.12 | $223.87 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $229.09 Typical High $398.11 | Professional | None | $125.89 | $229.09 | $398.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $158.49 Median $316.23 Typical High $389.05 | Professional | None | $158.49 | $316.23 | $389.05 |
Medcost Setting Professional Modifier None Typical Low $223.87 Median $281.84 Typical High $281.84 | Professional | None | $223.87 | $281.84 | $281.84 |
Medcost Setting Facility Modifier None Typical Low $131.83 Median $213.80 Typical High $436.52 | Facility | None | $131.83 | $213.80 | $436.52 |
Medcost Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
Sentara Setting Facility Modifier None Typical Low $109.65 Median $371.54 Typical High $2,454.71 | Facility | None | $109.65 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $173.78 Median $323.59 Typical High $1,148.15 | Professional | None | $173.78 | $323.59 | $1,148.15 |
United Setting Facility Modifier None Typical Low $100.00 Median $660.69 Typical High $2,089.30 | Facility | None | $100.00 | $660.69 | $2,089.30 |
United Setting Professional Modifier None Typical Low $102.33 Median $208.93 Typical High $436.52 | Professional | None | $102.33 | $208.93 | $436.52 |
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 $66.07 Median $91.20 Typical High $169.82 | Professional | 52 · Reduced service | $66.07 | $91.20 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $36.31 Typical High $69.18 | Professional | 53 · Discontinued | $26.30 | $36.31 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $138.04 Typical High $257.04 | Professional | 54 · Surgery only | $100.00 | $138.04 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $27.54 Typical High $51.29 | Professional | 55 · Aftercare only | $19.95 | $27.54 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $18.20 Typical High $34.67 | Professional | 56 · Pre-op care only | $13.18 | $18.20 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $128.82 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $93.33 | $128.82 | $239.88 |
Where Virginia sits
The same service costs 3.9 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
$170
AK $562KY $145
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.