How much rates vary
Facilitymedian $1,622 · 10th to 90th $117 to $5,754Professionalmedian $126 · 10th to 90th $98 to $229
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 $125.89 Median $4,365.16 Typical High $14,125.38 | Facility | None | $125.89 | $4,365.16 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $141.25 Typical High $190.55 | Professional | None | $109.65 | $141.25 | $190.55 |
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 $97.72 Median $117.49 Typical High $147.91 | Professional | None | $97.72 | $117.49 | $147.91 |
CareFirst Setting Professional Modifier None Typical Low $104.71 Median $114.82 Typical High $691.83 | Professional | None | $104.71 | $114.82 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $309.03 Typical High $1,621.81 | Facility | None | $114.82 | $309.03 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $151.36 Typical High $229.09 | Professional | None | $104.71 | $151.36 | $229.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $93.33 Median $181.97 Typical High $223.87 | Professional | None | $93.33 | $181.97 | $223.87 |
Medcost Setting Professional Modifier None Typical Low $154.88 Median $194.98 Typical High $194.98 | Professional | None | $154.88 | $194.98 | $194.98 |
Medcost Setting Facility Modifier None Typical Low $109.65 Median $165.96 Typical High $269.15 | Facility | None | $109.65 | $165.96 | $269.15 |
Medcost Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
Sentara Setting Facility Modifier None Typical Low $85.11 Median $891.25 Typical High $3,630.78 | Facility | None | $85.11 | $891.25 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $131.83 Median $190.55 Typical High $2,137.96 | Professional | None | $131.83 | $190.55 | $2,137.96 |
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 $81.28 Median $147.91 Typical High $257.04 | Professional | None | $81.28 | $147.91 | $257.04 |
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 $54.95 Median $67.61 Typical High $95.50 | Professional | 52 · Reduced service | $54.95 | $67.61 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $26.92 Typical High $38.02 | Professional | 53 · Discontinued | $21.88 | $26.92 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $100.00 Typical High $141.25 | Professional | 54 · Surgery only | $83.18 | $100.00 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $19.95 Typical High $28.18 | Professional | 55 · Aftercare only | $16.60 | $19.95 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $13.49 Typical High $19.05 | Professional | 56 · Pre-op care only | $10.96 | $13.49 | $19.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $93.33 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $77.62 | $93.33 | $131.83 |
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· 49th of 51
$138
AK $417KY $95.50
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.