How much rates vary
Facilitymedian $1,738 · 10th to 90th $309 to $5,754Professionalmedian $282 · 10th to 90th $200 to $447
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 $323.59 Median $3,801.89 Typical High $9,332.54 | Facility | None | $323.59 | $3,801.89 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $323.59 Typical High $588.84 | Professional | None | $234.42 | $323.59 | $588.84 |
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 $199.53 Median $263.03 Typical High $354.81 | Professional | None | $199.53 | $263.03 | $354.81 |
CareFirst Setting Professional Modifier None Typical Low $190.55 Median $213.80 Typical High $2,818.38 | Professional | None | $190.55 | $213.80 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $741.31 Typical High $1,659.59 | Facility | None | $346.74 | $741.31 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $281.84 Typical High $436.52 | Professional | None | $208.93 | $281.84 | $436.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $186.21 Median $323.59 Typical High $398.11 | Professional | None | $186.21 | $323.59 | $398.11 |
Medcost Setting Professional Modifier None Typical Low $323.59 Median $407.38 Typical High $407.38 | Professional | None | $323.59 | $407.38 | $407.38 |
Medcost Setting Facility Modifier None Typical Low $263.03 Median $354.81 Typical High $575.44 | Facility | None | $263.03 | $354.81 | $575.44 |
Medcost Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
Sentara Setting Facility Modifier None Typical Low $208.93 Median $954.99 Typical High $3,981.07 | Facility | None | $208.93 | $954.99 | $3,981.07 |
Sentara Setting Professional Modifier None Typical Low $257.04 Median $371.54 Typical High $2,137.96 | Professional | None | $257.04 | $371.54 | $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 $190.55 Median $331.13 Typical High $524.81 | Professional | None | $190.55 | $331.13 | $524.81 |
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 $117.49 Median $131.83 Typical High $177.83 | Professional | 52 · Reduced service | $117.49 | $131.83 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $53.70 Typical High $70.79 | Professional | 53 · Discontinued | $46.77 | $53.70 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $199.53 Typical High $263.03 | Professional | 54 · Surgery only | $177.83 | $199.53 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $39.81 Typical High $52.48 | Professional | 55 · Aftercare only | $35.48 | $39.81 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $26.30 Typical High $35.48 | Professional | 56 · Pre-op care only | $23.44 | $26.30 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $186.21 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $165.96 | $186.21 | $245.47 |
Where Virginia sits
The same service costs 4.3 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· 46th of 51
$288
AK $1,000UT $234
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.