How much rates vary
Facilitymedian $1,349 · 10th to 90th $151 to $5,623Professionalmedian $174 · 10th to 90th $105 to $275
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 $151.36 Median $501.19 Typical High $8,317.64 | Facility | None | $151.36 | $501.19 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $218.78 Typical High $281.84 | Professional | None | $123.03 | $218.78 | $281.84 |
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 $107.15 Median $177.83 Typical High $263.03 | Professional | None | $107.15 | $177.83 | $263.03 |
CareFirst Setting Professional Modifier None Typical Low $104.71 Median $117.49 Typical High $138.04 | Professional | None | $104.71 | $117.49 | $138.04 |
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 $107.15 Median $194.98 Typical High $269.15 | Professional | None | $107.15 | $194.98 | $269.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $208.93 Median $245.47 Typical High $338.84 | Professional | None | $208.93 | $245.47 | $338.84 |
Medcost Setting Professional Modifier None Typical Low $208.93 Median $263.03 Typical High $263.03 | Professional | None | $208.93 | $263.03 | $263.03 |
Medcost Setting Facility Modifier None Typical Low $123.03 Median $199.53 Typical High $380.19 | Facility | None | $123.03 | $199.53 | $380.19 |
Medcost Setting Professional Modifier None Typical Low $75.86 Median $131.83 Typical High $239.88 | Professional | None | $75.86 | $131.83 | $239.88 |
Sentara Setting Facility Modifier None Typical Low $97.72 Median $912.01 Typical High $3,630.78 | Facility | None | $97.72 | $912.01 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $165.96 Median $229.09 Typical High $354.81 | Professional | None | $165.96 | $229.09 | $354.81 |
United Setting Facility Modifier None Typical Low $602.56 Median $2,187.76 Typical High $5,888.44 | Facility | None | $602.56 | $2,187.76 | $5,888.44 |
United Setting Professional Modifier None Typical Low $89.13 Median $165.96 Typical High $288.40 | Professional | None | $89.13 | $165.96 | $288.40 |
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 $60.26 Median $81.28 Typical High $134.90 | Professional | 52 · Reduced service | $60.26 | $81.28 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $32.36 Typical High $53.70 | Professional | 53 · Discontinued | $24.55 | $32.36 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $120.23 Typical High $204.17 | Professional | 54 · Surgery only | $91.20 | $120.23 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $23.99 Typical High $40.74 | Professional | 55 · Aftercare only | $18.20 | $23.99 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $16.22 Typical High $26.92 | Professional | 56 · Pre-op care only | $12.30 | $16.22 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $112.20 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $85.11 | $112.20 | $190.55 |
Where Virginia sits
The same service costs 3.3 times more in Alaska than in Washington, DC. 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· 38th of 51
$178
AK $447DC $135
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.