How much rates vary
Facilitymedian $2,138 · 10th to 90th $245 to $7,079Professionalmedian $269 · 10th to 90th $200 to $417
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 $239.88 Median $4,786.30 Typical High $9,332.54 | Facility | None | $239.88 | $4,786.30 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $239.88 Typical High $478.63 | Professional | None | $181.97 | $239.88 | $478.63 |
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 $208.93 Median $275.42 Typical High $371.54 | Professional | None | $208.93 | $275.42 | $371.54 |
CareFirst Setting Professional Modifier None Typical Low $208.93 Median $234.42 Typical High $3,162.28 | Professional | None | $208.93 | $234.42 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,258.93 Typical High $2,570.40 | Facility | None | $524.81 | $1,258.93 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $269.15 Typical High $416.87 | Professional | None | $204.17 | $269.15 | $416.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $181.97 Median $316.23 Typical High $389.05 | Professional | None | $181.97 | $316.23 | $389.05 |
Medcost Setting Professional Modifier None Typical Low $281.84 Median $354.81 Typical High $354.81 | Professional | None | $281.84 | $354.81 | $354.81 |
Medcost Setting Facility Modifier None Typical Low $229.09 Median $263.03 Typical High $426.58 | Facility | None | $229.09 | $263.03 | $426.58 |
Medcost Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
Sentara Setting Facility Modifier None Typical Low $177.83 Median $954.99 Typical High $8,709.64 | Facility | None | $177.83 | $954.99 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $218.78 Median $316.23 Typical High $4,570.88 | Professional | None | $218.78 | $316.23 | $4,570.88 |
United Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $5,888.44 | Facility | None | $588.84 | $2,187.76 | $5,888.44 |
United Setting Professional Modifier None Typical Low $169.82 Median $281.84 Typical High $457.09 | Professional | None | $169.82 | $281.84 | $457.09 |
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 $120.23 Typical High $131.83 | Professional | 52 · Reduced service | $91.20 | $120.23 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $47.86 Typical High $52.48 | Professional | 53 · Discontinued | $36.31 | $47.86 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $177.83 Typical High $199.53 | Professional | 54 · Surgery only | $134.90 | $177.83 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $35.48 Typical High $39.81 | Professional | 55 · Aftercare only | $26.92 | $35.48 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $23.99 Typical High $26.30 | Professional | 56 · Pre-op care only | $18.20 | $23.99 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $165.96 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $125.89 | $165.96 | $186.21 |
Where Virginia sits
The same service costs 4.7 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· 40th of 51
$282
AK $1,000KY $214
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.