How much rates vary
Facilitymedian $575 · 10th to 90th $102 to $4,074Professionalmedian $151 · 10th to 90th $107 to $219
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 $128.82 Median $4,073.80 Typical High $10,000.00 | Facility | None | $128.82 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $165.96 Typical High $213.80 | Professional | None | $125.89 | $165.96 | $213.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $2,398.83 Typical High $2,951.21 | Facility | None | $1,698.24 | $2,398.83 | $2,951.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $104.71 Median $154.88 Typical High $213.80 | Professional | None | $104.71 | $154.88 | $213.80 |
CareFirst Setting Professional Modifier None Typical Low $107.15 Median $120.23 Typical High $138.04 | Professional | None | $107.15 | $120.23 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $131.83 Typical High $245.47 | Facility | None | $50.12 | $131.83 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $162.18 Typical High $213.80 | Professional | None | $107.15 | $162.18 | $213.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $181.97 Median $208.93 Typical High $288.40 | Professional | None | $181.97 | $208.93 | $288.40 |
Medcost Setting Professional Modifier None Typical Low $181.97 Median $223.87 Typical High $234.42 | Professional | None | $181.97 | $223.87 | $234.42 |
Medcost Setting Facility Modifier None Typical Low $125.89 Median $199.53 Typical High $323.59 | Facility | None | $125.89 | $199.53 | $323.59 |
Medcost Setting Professional Modifier None Typical Low $165.96 Median $177.83 Typical High $208.93 | Professional | None | $165.96 | $177.83 | $208.93 |
Sentara Setting Facility Modifier None Typical Low $102.33 Median $371.54 Typical High $2,454.71 | Facility | None | $102.33 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $125.89 Median $190.55 Typical High $288.40 | Professional | None | $125.89 | $190.55 | $288.40 |
United Setting Facility Modifier None Typical Low $100.00 Median $660.69 Typical High $2,089.30 | Facility | None | $100.00 | $660.69 | $2,089.30 |
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 $107.15 | Professional | 52 · Reduced service | $63.10 | $77.62 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $30.90 Typical High $43.65 | Professional | 53 · Discontinued | $25.12 | $30.90 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $114.82 Typical High $162.18 | Professional | 54 · Surgery only | $93.33 | $114.82 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $23.44 Typical High $32.36 | Professional | 55 · Aftercare only | $18.62 | $23.44 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $15.49 Typical High $21.38 | Professional | 56 · Pre-op care only | $12.59 | $15.49 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $107.15 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $87.10 | $107.15 | $151.36 |
Where Virginia sits
The same service costs 3.5 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· 38th of 51
$151
AK $437NJ $126
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.