How much rates vary
Facilitymedian $2,089 · 10th to 90th $355 to $6,026Professionalmedian $339 · 10th to 90th $251 to $479
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 $407.38 Median $3,981.07 Typical High $9,332.54 | Facility | None | $407.38 | $3,981.07 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $363.08 Typical High $446.68 | Professional | None | $309.03 | $363.08 | $446.68 |
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 $251.19 Median $346.74 Typical High $446.68 | Professional | None | $251.19 | $346.74 | $446.68 |
CareFirst Setting Professional Modifier None Typical Low $251.19 Median $281.84 Typical High $331.13 | Professional | None | $251.19 | $281.84 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,513.56 Typical High $2,818.38 | Facility | None | $478.63 | $1,513.56 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $354.81 Typical High $489.78 | Professional | None | $263.03 | $354.81 | $489.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $363.08 Median $416.87 Typical High $616.60 | Professional | None | $363.08 | $416.87 | $616.60 |
Medcost Setting Professional Modifier None Typical Low $398.11 Median $501.19 Typical High $501.19 | Professional | None | $398.11 | $501.19 | $501.19 |
Medcost Setting Facility Modifier None Typical Low $309.03 Median $407.38 Typical High $676.08 | Facility | None | $309.03 | $407.38 | $676.08 |
Medcost Setting Professional Modifier None Typical Low $275.42 Median $346.74 Typical High $436.52 | Professional | None | $275.42 | $346.74 | $436.52 |
Sentara Setting Facility Modifier None Typical Low $251.19 Median $1,047.13 Typical High $3,981.07 | Facility | None | $251.19 | $1,047.13 | $3,981.07 |
Sentara Setting Professional Modifier None Typical Low $331.13 Median $407.38 Typical High $616.60 | Professional | None | $331.13 | $407.38 | $616.60 |
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 $223.87 Median $323.59 Typical High $549.54 | Professional | None | $223.87 | $323.59 | $549.54 |
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 $154.88 Median $173.78 Typical High $218.78 | Professional | 52 · Reduced service | $154.88 | $173.78 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $69.18 Typical High $89.13 | Professional | 53 · Discontinued | $63.10 | $69.18 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $263.03 Typical High $331.13 | Professional | 54 · Surgery only | $234.42 | $263.03 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $52.48 Typical High $66.07 | Professional | 55 · Aftercare only | $46.77 | $52.48 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $34.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $30.90 | $34.67 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $245.47 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $218.78 | $245.47 | $309.03 |
Where Virginia sits
The same service costs 4.1 times more in Alaska than in New Jersey. 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· 36th of 51
$347
AK $1,072NJ $263
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.