How much rates vary
Facilitymedian $501 · 10th to 90th $89 to $3,802Professionalmedian $148 · 10th to 90th $112 to $224
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 $131.83 Median $4,365.16 Typical High $14,125.38 | Facility | None | $131.83 | $4,365.16 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $158.49 Typical High $257.04 | Professional | None | $125.89 | $158.49 | $257.04 |
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 $112.20 Median $144.54 Typical High $194.98 | Professional | None | $112.20 | $144.54 | $194.98 |
CareFirst Setting Professional Modifier None Typical Low $120.23 Median $131.83 Typical High $691.83 | Professional | None | $120.23 | $131.83 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $1,230.27 | Facility | None | $50.12 | $50.12 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $147.91 Typical High $223.87 | Professional | None | $112.20 | $147.91 | $223.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $97.72 Median $169.82 Typical High $208.93 | Professional | None | $97.72 | $169.82 | $208.93 |
Medcost Setting Professional Modifier None Typical Low $141.25 Median $177.83 Typical High $177.83 | Professional | None | $141.25 | $177.83 | $177.83 |
Medcost Setting Facility Modifier None Typical Low $125.89 Median $158.49 Typical High $257.04 | Facility | None | $125.89 | $158.49 | $257.04 |
Medcost Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
Sentara Setting Facility Modifier None Typical Low $89.13 Median $302.00 Typical High $2,454.71 | Facility | None | $89.13 | $302.00 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $128.82 Median $181.97 Typical High $870.96 | Professional | None | $128.82 | $181.97 | $870.96 |
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 $93.33 Median $154.88 Typical High $251.19 | Professional | None | $93.33 | $154.88 | $251.19 |
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 $61.66 Median $69.18 Typical High $87.10 | Professional | 52 · Reduced service | $61.66 | $69.18 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $27.54 Typical High $34.67 | Professional | 53 · Discontinued | $25.12 | $27.54 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $102.33 Typical High $131.83 | Professional | 54 · Surgery only | $93.33 | $102.33 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $20.42 Typical High $26.30 | Professional | 55 · Aftercare only | $18.62 | $20.42 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $13.80 Typical High $17.38 | Professional | 56 · Pre-op care only | $12.59 | $13.80 | $17.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $95.50 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $87.10 | $95.50 | $123.03 |
Where Virginia sits
The same service costs 4.1 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· 33rd of 51
$155
AK $457KY $112
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.