How much rates vary
Facilitymedian $603 · 10th to 90th $145 to $4,074Professionalmedian $204 · 10th to 90th $132 to $302
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 $162.18 Median $4,073.80 Typical High $10,000.00 | Facility | None | $162.18 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $251.19 Typical High $288.40 | Professional | None | $154.88 | $251.19 | $288.40 |
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 $131.83 Median $204.17 Typical High $295.12 | Professional | None | $131.83 | $204.17 | $295.12 |
CareFirst Setting Professional Modifier None Typical Low $138.04 Median $154.88 Typical High $177.83 | Professional | None | $138.04 | $154.88 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $380.19 Typical High $1,621.81 | Facility | None | $199.53 | $380.19 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $223.87 Typical High $302.00 | Professional | None | $134.90 | $223.87 | $302.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $263.03 Median $309.03 Typical High $407.38 | Professional | None | $263.03 | $309.03 | $407.38 |
Medcost Setting Professional Modifier None Typical Low $223.87 Median $281.84 Typical High $316.23 | Professional | None | $223.87 | $281.84 | $316.23 |
Medcost Setting Facility Modifier None Typical Low $154.88 Median $251.19 Typical High $436.52 | Facility | None | $154.88 | $251.19 | $436.52 |
Medcost Setting Professional Modifier None Typical Low $44.67 Median $114.82 Typical High $281.84 | Professional | None | $44.67 | $114.82 | $281.84 |
Sentara Setting Facility Modifier None Typical Low $120.23 Median $371.54 Typical High $2,454.71 | Facility | None | $120.23 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $208.93 Median $257.04 Typical High $398.11 | Professional | None | $208.93 | $257.04 | $398.11 |
United Setting Facility Modifier None Typical Low $100.00 Median $660.69 Typical High $2,041.74 | Facility | None | $100.00 | $660.69 | $2,041.74 |
United Setting Professional Modifier None Typical Low $112.20 Median $186.21 Typical High $316.23 | Professional | None | $112.20 | $186.21 | $316.23 |
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 $75.86 Median $97.72 Typical High $144.54 | Professional | 52 · Reduced service | $75.86 | $97.72 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $38.90 Typical High $58.88 | Professional | 53 · Discontinued | $30.90 | $38.90 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $147.91 Typical High $218.78 | Professional | 54 · Surgery only | $114.82 | $147.91 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $29.51 Typical High $43.65 | Professional | 55 · Aftercare only | $22.91 | $29.51 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $19.50 Typical High $28.84 | Professional | 56 · Pre-op care only | $15.49 | $19.50 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $138.04 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $107.15 | $138.04 | $204.17 |
Where Virginia sits
The same service costs 3.5 times more in Alaska than in Washington, DC. 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
$209
AK $562DC $162
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.