How much rates vary
Facilitymedian $2,138 · 10th to 90th $224 to $6,166Professionalmedian $204 · 10th to 90th $166 to $324
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 $190.55 Median $4,786.30 Typical High $14,125.38 | Facility | None | $190.55 | $4,786.30 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $190.55 Typical High $3,162.28 | Professional | None | $154.88 | $190.55 | $3,162.28 |
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 $169.82 Median $204.17 Typical High $263.03 | Professional | None | $169.82 | $204.17 | $263.03 |
CareFirst Setting Professional Modifier None Typical Low $177.83 Median $199.53 Typical High $1,659.59 | Professional | None | $177.83 | $199.53 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,412.54 Typical High $2,691.53 | Facility | None | $512.86 | $1,412.54 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $199.53 Typical High $302.00 | Professional | None | $169.82 | $199.53 | $302.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $186.21 Typical High $229.09 | Professional | None | $154.88 | $186.21 | $229.09 |
Medcost Setting Professional Modifier None Typical Low $218.78 Median $275.42 Typical High $275.42 | Professional | None | $218.78 | $275.42 | $275.42 |
Medcost Setting Facility Modifier None Typical Low $190.55 Median $223.87 Typical High $309.03 | Facility | None | $190.55 | $223.87 | $309.03 |
Medcost Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
Sentara Setting Facility Modifier None Typical Low $154.88 Median $933.25 Typical High $3,630.78 | Facility | None | $154.88 | $933.25 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $169.82 Median $223.87 Typical High $2,137.96 | Professional | None | $169.82 | $223.87 | $2,137.96 |
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 $141.25 Median $223.87 Typical High $338.84 | Professional | None | $141.25 | $223.87 | $338.84 |
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 $77.62 Median $95.50 Typical High $95.50 | Professional | 52 · Reduced service | $77.62 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $38.02 Typical High $38.02 | Professional | 53 · Discontinued | $30.90 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $141.25 Typical High $141.25 | Professional | 54 · Surgery only | $114.82 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $28.84 Typical High $28.84 | Professional | 55 · Aftercare only | $22.91 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $19.05 Typical High $19.05 | Professional | 56 · Pre-op care only | $15.49 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $131.83 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $107.15 | $131.83 | $131.83 |
Where Virginia sits
The same service costs 8.7 times more in Oklahoma than in Utah. 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· 43rd of 51
$214
OK $1,349UT $155
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.