How much rates vary
Facilitymedian $1,862 · 10th to 90th $200 to $6,166Professionalmedian $229 · 10th to 90th $155 to $331
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 $199.53 Median $4,365.16 Typical High $10,000.00 | Facility | None | $199.53 | $4,365.16 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $281.84 Typical High $309.03 | Professional | None | $190.55 | $281.84 | $309.03 |
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 $154.88 Median $229.09 Typical High $302.00 | Professional | None | $154.88 | $229.09 | $302.00 |
CareFirst Setting Professional Modifier None Typical Low $151.36 Median $169.82 Typical High $194.98 | Professional | None | $151.36 | $169.82 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $446.68 Typical High $2,187.76 | Facility | None | $186.21 | $446.68 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $245.47 Typical High $354.81 | Professional | None | $162.18 | $245.47 | $354.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $257.04 Median $302.00 Typical High $467.74 | Professional | None | $257.04 | $302.00 | $467.74 |
Medcost Setting Professional Modifier None Typical Low $269.15 Median $338.84 Typical High $338.84 | Professional | None | $269.15 | $338.84 | $338.84 |
Medcost Setting Facility Modifier None Typical Low $199.53 Median $302.00 Typical High $501.19 | Facility | None | $199.53 | $302.00 | $501.19 |
Medcost Setting Professional Modifier None Typical Low $208.93 Median $239.88 Typical High $316.23 | Professional | None | $208.93 | $239.88 | $316.23 |
Sentara Setting Facility Modifier None Typical Low $173.78 Median $912.01 Typical High $3,981.07 | Facility | None | $173.78 | $912.01 | $3,981.07 |
Sentara Setting Professional Modifier None Typical Low $186.21 Median $295.12 Typical High $457.09 | Professional | None | $186.21 | $295.12 | $457.09 |
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 $138.04 Median $218.78 Typical High $380.19 | Professional | None | $138.04 | $218.78 | $380.19 |
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 $95.50 Median $117.49 Typical High $154.88 | Professional | 52 · Reduced service | $95.50 | $117.49 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $46.77 Typical High $61.66 | Professional | 53 · Discontinued | $38.90 | $46.77 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $173.78 Typical High $234.42 | Professional | 54 · Surgery only | $144.54 | $173.78 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $34.67 Typical High $46.77 | Professional | 55 · Aftercare only | $28.84 | $34.67 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $23.44 Typical High $30.90 | Professional | 56 · Pre-op care only | $19.05 | $23.44 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $162.18 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $134.90 | $162.18 | $218.78 |
Where Virginia sits
The same service costs 3.6 times more in Alaska than in Texas. 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· 39th of 51
$229
AK $646TX $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.