How much rates vary
Facilitymedian $933 · 10th to 90th $234 to $4,365Professionalmedian $257 · 10th to 90th $182 to $372
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 $269.15 Median $602.56 Typical High $8,317.64 | Facility | None | $269.15 | $602.56 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $302.00 Typical High $389.05 | Professional | None | $213.80 | $302.00 | $389.05 |
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 $186.21 Median $257.04 Typical High $346.74 | Professional | None | $186.21 | $257.04 | $346.74 |
CareFirst Setting Professional Modifier None Typical Low $186.21 Median $208.93 Typical High $239.88 | Professional | None | $186.21 | $208.93 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $239.88 Median $407.38 Typical High $1,621.81 | Facility | None | $239.88 | $407.38 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $269.15 Typical High $354.81 | Professional | None | $190.55 | $269.15 | $354.81 |
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 $199.53 Median $302.00 Typical High $323.59 | Professional | None | $199.53 | $302.00 | $323.59 |
Medcost Setting Facility Modifier None Typical Low $213.80 Median $302.00 Typical High $501.19 | Facility | None | $213.80 | $302.00 | $501.19 |
Medcost Setting Professional Modifier None Typical Low $104.71 Median $128.82 Typical High $302.00 | Professional | None | $104.71 | $128.82 | $302.00 |
Sentara Setting Facility Modifier None Typical Low $147.91 Median $616.60 Typical High $2,951.21 | Facility | None | $147.91 | $616.60 | $2,951.21 |
Sentara Setting Professional Modifier None Typical Low $169.82 Median $288.40 Typical High $467.74 | Professional | None | $169.82 | $288.40 | $467.74 |
United Setting Facility Modifier None Typical Low $323.59 Median $1,445.44 Typical High $3,630.78 | Facility | None | $323.59 | $1,445.44 | $3,630.78 |
United Setting Professional Modifier None Typical Low $147.91 Median $223.87 Typical High $389.05 | Professional | None | $147.91 | $223.87 | $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 $173.78 | Professional | 52 · Reduced service | $107.15 | $134.90 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $53.70 Typical High $69.18 | Professional | 53 · Discontinued | $42.66 | $53.70 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $199.53 Typical High $257.04 | Professional | 54 · Surgery only | $162.18 | $199.53 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $39.81 Typical High $51.29 | Professional | 55 · Aftercare only | $32.36 | $39.81 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $26.92 Typical High $34.67 | Professional | 56 · Pre-op care only | $21.38 | $26.92 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $186.21 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $151.36 | $186.21 | $239.88 |
Where Virginia sits
The same service costs 3.8 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· 37th of 51
$257
AK $776KY $204
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.