How much rates vary
Facilitymedian $1,820 · 10th to 90th $240 to $5,754Professionalmedian $257 · 10th to 90th $178 to $389
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 $239.88 Median $4,073.80 Typical High $10,000.00 | Facility | None | $239.88 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $281.84 Typical High $389.05 | Professional | None | $213.80 | $281.84 | $389.05 |
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 $186.21 Median $275.42 Typical High $371.54 | Professional | None | $186.21 | $275.42 | $371.54 |
CareFirst Setting Professional Modifier None Typical Low $177.83 Median $194.98 Typical High $229.09 | Professional | None | $177.83 | $194.98 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $457.09 Typical High $1,621.81 | Facility | None | $275.42 | $457.09 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $263.03 Typical High $363.08 | Professional | None | $190.55 | $263.03 | $363.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $316.23 Median $371.54 Typical High $467.74 | Professional | None | $316.23 | $371.54 | $467.74 |
Medcost Setting Professional Modifier None Typical Low $190.55 Median $257.04 Typical High $257.04 | Professional | None | $190.55 | $257.04 | $257.04 |
Medcost Setting Facility Modifier None Typical Low $208.93 Median $288.40 Typical High $524.81 | Facility | None | $208.93 | $288.40 | $524.81 |
Medcost Setting Professional Modifier None Typical Low $120.23 Median $128.82 Typical High $288.40 | Professional | None | $120.23 | $128.82 | $288.40 |
Sentara Setting Facility Modifier None Typical Low $131.83 Median $933.25 Typical High $3,981.07 | Facility | None | $131.83 | $933.25 | $3,981.07 |
Sentara Setting Professional Modifier None Typical Low $131.83 Median $295.12 Typical High $501.19 | Professional | None | $131.83 | $295.12 | $501.19 |
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 $144.54 Median $213.80 Typical High $389.05 | Professional | None | $144.54 | $213.80 | $389.05 |
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 $107.15 Median $134.90 Typical High $194.98 | Professional | 52 · Reduced service | $107.15 | $134.90 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $53.70 Typical High $77.62 | Professional | 53 · Discontinued | $42.66 | $53.70 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $204.17 Typical High $288.40 | Professional | 54 · Surgery only | $158.49 | $204.17 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $40.74 Typical High $57.54 | Professional | 55 · Aftercare only | $31.62 | $40.74 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $26.92 Typical High $38.90 | Professional | 56 · Pre-op care only | $21.38 | $26.92 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $190.55 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $147.91 | $190.55 | $269.15 |
Where Virginia sits
The same service costs 4.5 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· 35th of 51
$257
AK $794KY $178
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.