How much rates vary
Facilitymedian $1,175 · 10th to 90th $204 to $4,571Professionalmedian $245 · 10th to 90th $166 to $389
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 $223.87 Median $4,365.16 Typical High $14,125.38 | Facility | None | $223.87 | $4,365.16 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $251.19 Typical High $389.05 | Professional | None | $199.53 | $251.19 | $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 $177.83 Median $263.03 Typical High $380.19 | Professional | None | $177.83 | $263.03 | $380.19 |
CareFirst Setting Professional Modifier None Typical Low $162.18 Median $181.97 Typical High $208.93 | Professional | None | $162.18 | $181.97 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $512.86 Typical High $2,691.53 | Facility | None | $295.12 | $512.86 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $245.47 Typical High $354.81 | Professional | None | $165.96 | $245.47 | $354.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $354.81 Median $416.87 Typical High $524.81 | Professional | None | $354.81 | $416.87 | $524.81 |
Medcost Setting Professional Modifier None Typical Low $190.55 Median $234.42 Typical High $257.04 | Professional | None | $190.55 | $234.42 | $257.04 |
Medcost Setting Facility Modifier None Typical Low $154.88 Median $257.04 Typical High $524.81 | Facility | None | $154.88 | $257.04 | $524.81 |
Medcost Setting Professional Modifier None Typical Low $63.10 Median $100.00 Typical High $295.12 | Professional | None | $63.10 | $100.00 | $295.12 |
Sentara Setting Facility Modifier None Typical Low $120.23 Median $616.60 Typical High $2,951.21 | Facility | None | $120.23 | $616.60 | $2,951.21 |
Sentara Setting Professional Modifier None Typical Low $169.82 Median $275.42 Typical High $489.78 | Professional | None | $169.82 | $275.42 | $489.78 |
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 $117.49 Median $190.55 Typical High $363.08 | Professional | None | $117.49 | $190.55 | $363.08 |
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 $100.00 Median $125.89 Typical High $194.98 | Professional | 52 · Reduced service | $100.00 | $125.89 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $50.12 Typical High $77.62 | Professional | 53 · Discontinued | $39.81 | $50.12 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $186.21 Typical High $288.40 | Professional | 54 · Surgery only | $151.36 | $186.21 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $37.15 Typical High $58.88 | Professional | 55 · Aftercare only | $30.20 | $37.15 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $25.12 Typical High $38.90 | Professional | 56 · Pre-op care only | $19.95 | $25.12 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $173.78 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $141.25 | $173.78 | $269.15 |
Where Virginia sits
The same service costs 4.5 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
$245
AK $741KY $166
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.