How much rates vary
Facilitymedian $1,862 · 10th to 90th $138 to $6,166Professionalmedian $158 · 10th to 90th $107 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 $131.83 Median $4,365.16 Typical High $10,000.00 | Facility | None | $131.83 | $4,365.16 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $194.98 Typical High $229.09 | Professional | None | $125.89 | $194.98 | $229.09 |
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 $158.49 Typical High $229.09 | Professional | None | $107.15 | $158.49 | $229.09 |
CareFirst Setting Professional Modifier None Typical Low $109.65 Median $123.03 Typical High $141.25 | Professional | None | $109.65 | $123.03 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $426.58 Typical High $2,187.76 | Facility | None | $138.04 | $426.58 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $169.82 Typical High $229.09 | Professional | None | $109.65 | $169.82 | $229.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $186.21 Median $218.78 Typical High $302.00 | Professional | None | $186.21 | $218.78 | $302.00 |
Medcost Setting Professional Modifier None Typical Low $186.21 Median $229.09 Typical High $229.09 | Professional | None | $186.21 | $229.09 | $229.09 |
Medcost Setting Facility Modifier None Typical Low $125.89 Median $194.98 Typical High $323.59 | Facility | None | $125.89 | $194.98 | $323.59 |
Medcost Setting Professional Modifier None Typical Low $100.00 Median $151.36 Typical High $204.17 | Professional | None | $100.00 | $151.36 | $204.17 |
Sentara Setting Facility Modifier None Typical Low $104.71 Median $891.25 Typical High $3,981.07 | Facility | None | $104.71 | $891.25 | $3,981.07 |
Sentara Setting Professional Modifier None Typical Low $147.91 Median $190.55 Typical High $302.00 | Professional | None | $147.91 | $190.55 | $302.00 |
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 $89.13 Median $144.54 Typical High $245.47 | Professional | None | $89.13 | $144.54 | $245.47 |
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 $63.10 Median $77.62 Typical High $114.82 | Professional | 52 · Reduced service | $63.10 | $77.62 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $30.90 Typical High $45.71 | Professional | 53 · Discontinued | $25.12 | $30.90 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $114.82 Typical High $173.78 | Professional | 54 · Surgery only | $93.33 | $114.82 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $22.91 Typical High $34.67 | Professional | 55 · Aftercare only | $18.62 | $22.91 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $15.49 Typical High $22.91 | Professional | 56 · Pre-op care only | $12.59 | $15.49 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $107.15 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $87.10 | $107.15 | $162.18 |
Where Virginia sits
The same service costs 3.4 times more in Alaska than in Florida. 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· 35th of 51
$162
AK $447FL $132
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.