How much rates vary
Facilitymedian $2,692 · 10th to 90th $182 to $9,550Professionalmedian $204 · 10th to 90th $158 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 $181.97 Median $4,073.80 Typical High $10,000.00 | Facility | None | $181.97 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $204.17 Typical High $389.05 | Professional | None | $181.97 | $204.17 | $389.05 |
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 $158.49 Median $199.53 Typical High $251.19 | Professional | None | $158.49 | $199.53 | $251.19 |
CareFirst Setting Professional Modifier None Typical Low $173.78 Median $190.55 Typical High $2,511.89 | Professional | None | $173.78 | $190.55 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $173.78 Typical High $2,691.53 | Facility | None | $89.13 | $173.78 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $208.93 Typical High $316.23 | Professional | None | $162.18 | $208.93 | $316.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $144.54 Median $223.87 Typical High $275.42 | Professional | None | $144.54 | $223.87 | $275.42 |
Medcost Setting Professional Modifier None Typical Low $251.19 Median $316.23 Typical High $316.23 | Professional | None | $251.19 | $316.23 | $316.23 |
Medcost Setting Facility Modifier None Typical Low $181.97 Median $223.87 Typical High $338.84 | Facility | None | $181.97 | $223.87 | $338.84 |
Medcost Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
Sentara Setting Facility Modifier None Typical Low $154.88 Median $933.25 Typical High $8,709.64 | Facility | None | $154.88 | $933.25 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $190.55 Median $251.19 Typical High $4,570.88 | Professional | None | $190.55 | $251.19 | $4,570.88 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $4,897.79 Typical High $13,182.57 | Facility | None | $1,230.27 | $4,897.79 | $13,182.57 |
United Setting Professional Modifier None Typical Low $147.91 Median $234.42 Typical High $354.81 | Professional | None | $147.91 | $234.42 | $354.81 |
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 $91.20 Median $95.50 Typical High $104.71 | Professional | 52 · Reduced service | $91.20 | $95.50 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $38.90 Typical High $41.69 | Professional | 53 · Discontinued | $36.31 | $38.90 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $144.54 Typical High $154.88 | Professional | 54 · Surgery only | $134.90 | $144.54 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $28.84 Typical High $31.62 | Professional | 55 · Aftercare only | $26.92 | $28.84 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $19.05 Typical High $20.89 | Professional | 56 · Pre-op care only | $18.20 | $19.05 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $134.90 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $125.89 | $134.90 | $144.54 |
Where Virginia sits
The same service costs 4.9 times more in Oklahoma than in Florida. 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
$209
OK $891FL $182
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.