How much rates vary
Facilitymedian $2,692 · 10th to 90th $126 to $9,550Professionalmedian $155 · 10th to 90th $110 to $240
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 $138.04 Median $3,801.89 Typical High $9,332.54 | Facility | None | $138.04 | $3,801.89 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $138.04 Typical High $251.19 | Professional | None | $100.00 | $138.04 | $251.19 |
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 $112.20 Median $158.49 Typical High $223.87 | Professional | None | $112.20 | $158.49 | $223.87 |
CareFirst Setting Professional Modifier None Typical Low $114.82 Median $128.82 Typical High $3,162.28 | Professional | None | $114.82 | $128.82 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $223.87 Typical High $2,691.53 | Facility | None | $114.82 | $223.87 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $151.36 Typical High $251.19 | Professional | None | $109.65 | $151.36 | $251.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $102.33 Median $190.55 Typical High $234.42 | Professional | None | $102.33 | $190.55 | $234.42 |
Medcost Setting Professional Modifier None Typical Low $147.91 Median $186.21 Typical High $186.21 | Professional | None | $147.91 | $186.21 | $186.21 |
Medcost Setting Facility Modifier None Typical Low $114.82 Median $138.04 Typical High $223.87 | Facility | None | $114.82 | $138.04 | $223.87 |
Medcost Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
Sentara Setting Facility Modifier None Typical Low $91.20 Median $912.01 Typical High $8,709.64 | Facility | None | $91.20 | $912.01 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $120.23 Median $173.78 Typical High $4,570.88 | Professional | None | $120.23 | $173.78 | $4,570.88 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,011.87 Typical High $13,182.57 | Facility | None | $1,230.27 | $5,011.87 | $13,182.57 |
United Setting Professional Modifier None Typical Low $89.13 Median $144.54 Typical High $245.47 | Professional | None | $89.13 | $144.54 | $245.47 |
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 $50.12 Median $66.07 Typical High $74.13 | Professional | 52 · Reduced service | $50.12 | $66.07 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $26.30 Typical High $29.51 | Professional | 53 · Discontinued | $19.95 | $26.30 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $100.00 Typical High $109.65 | Professional | 54 · Surgery only | $74.13 | $100.00 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $19.95 Typical High $21.88 | Professional | 55 · Aftercare only | $14.79 | $19.95 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $13.18 Typical High $14.79 | Professional | 56 · Pre-op care only | $10.00 | $13.18 | $14.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $93.33 Typical High $102.33 | Professional | 78 · Unplanned return to OR | $69.18 | $93.33 | $102.33 |
Where Virginia sits
The same service costs 3.7 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· 35th of 51
$158
AK $468KY $126
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.