How much rates vary
Facilitymedian $1,698 · 10th to 90th $200 to $5,754Professionalmedian $204 · 10th to 90th $148 to $282
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 $234.42 Median $3,981.07 Typical High $9,332.54 | Facility | None | $234.42 | $3,981.07 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $213.80 Typical High $263.03 | Professional | None | $169.82 | $213.80 | $263.03 |
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 $151.36 Median $208.93 Typical High $263.03 | Professional | None | $151.36 | $208.93 | $263.03 |
CareFirst Setting Professional Modifier None Typical Low $147.91 Median $165.96 Typical High $194.98 | Professional | None | $147.91 | $165.96 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $741.31 Typical High $1,659.59 | Facility | None | $346.74 | $741.31 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $208.93 Typical High $281.84 | Professional | None | $154.88 | $208.93 | $281.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $208.93 Median $245.47 Typical High $346.74 | Professional | None | $208.93 | $245.47 | $346.74 |
Medcost Setting Professional Modifier None Typical Low $234.42 Median $295.12 Typical High $295.12 | Professional | None | $234.42 | $295.12 | $295.12 |
Medcost Setting Facility Modifier None Typical Low $169.82 Median $234.42 Typical High $389.05 | Facility | None | $169.82 | $234.42 | $389.05 |
Medcost Setting Professional Modifier None Typical Low $165.96 Median $177.83 Typical High $251.19 | Professional | None | $165.96 | $177.83 | $251.19 |
Sentara Setting Facility Modifier None Typical Low $141.25 Median $912.01 Typical High $3,630.78 | Facility | None | $141.25 | $912.01 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $208.93 Median $239.88 Typical High $354.81 | Professional | None | $208.93 | $239.88 | $354.81 |
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 $125.89 Median $186.21 Typical High $309.03 | Professional | None | $125.89 | $186.21 | $309.03 |
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 $85.11 Median $102.33 Typical High $131.83 | Professional | 52 · Reduced service | $85.11 | $102.33 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $40.74 Typical High $52.48 | Professional | 53 · Discontinued | $34.67 | $40.74 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $154.88 Typical High $199.53 | Professional | 54 · Surgery only | $128.82 | $154.88 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $30.90 Typical High $39.81 | Professional | 55 · Aftercare only | $25.70 | $30.90 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $20.42 Typical High $26.30 | Professional | 56 · Pre-op care only | $16.98 | $20.42 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $144.54 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $120.23 | $144.54 | $186.21 |
Where Virginia sits
The same service costs 4.2 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
$204
AK $646NJ $155
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.