How much rates vary
Facilitymedian $1,698 · 10th to 90th $126 to $5,754Professionalmedian $141 · 10th to 90th $110 to $195
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 $4,073.80 Typical High $10,000.00 | Facility | None | $131.83 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $165.96 Typical High $186.21 | Professional | None | $123.03 | $165.96 | $186.21 |
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 $112.20 Median $141.25 Typical High $190.55 | Professional | None | $112.20 | $141.25 | $190.55 |
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 $100.00 Median $275.42 Typical High $1,621.81 | Facility | None | $100.00 | $275.42 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $141.25 Typical High $204.17 | Professional | None | $109.65 | $141.25 | $204.17 |
Kaiser Permanente Setting Professional Modifier None Typical Low $147.91 Median $169.82 Typical High $257.04 | Professional | None | $147.91 | $169.82 | $257.04 |
Medcost Setting Professional Modifier None Typical Low $169.82 Median $213.80 Typical High $213.80 | Professional | None | $169.82 | $213.80 | $213.80 |
Medcost Setting Facility Modifier None Typical Low $123.03 Median $165.96 Typical High $275.42 | Facility | None | $123.03 | $165.96 | $275.42 |
Medcost Setting Professional Modifier None Typical Low $100.00 Median $125.89 Typical High $186.21 | Professional | None | $100.00 | $125.89 | $186.21 |
Sentara Setting Facility Modifier None Typical Low $100.00 Median $891.25 Typical High $3,630.78 | Facility | None | $100.00 | $891.25 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $147.91 Median $177.83 Typical High $251.19 | Professional | None | $147.91 | $177.83 | $251.19 |
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 $87.10 Median $131.83 Typical High $223.87 | Professional | None | $87.10 | $131.83 | $223.87 |
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 $61.66 Median $70.79 Typical High $89.13 | Professional | 52 · Reduced service | $61.66 | $70.79 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $28.18 Typical High $35.48 | Professional | 53 · Discontinued | $24.55 | $28.18 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $104.71 Typical High $134.90 | Professional | 54 · Surgery only | $91.20 | $104.71 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $20.89 Typical High $26.92 | Professional | 55 · Aftercare only | $18.62 | $20.89 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $14.13 Typical High $17.78 | Professional | 56 · Pre-op care only | $12.30 | $14.13 | $17.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $97.72 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $85.11 | $97.72 | $125.89 |
Where Virginia sits
The same service costs 4.0 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
$141
AK $437NJ $110
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.