How much rates vary
Facilitymedian $3,090 · 10th to 90th $126 to $9,550Professionalmedian $155 · 10th to 90th $110 to $245
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 $125.89 Median $4,365.16 Typical High $10,000.00 | Facility | None | $125.89 | $4,365.16 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $144.54 Typical High $234.42 | Professional | None | $93.33 | $144.54 | $234.42 |
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 $109.65 Median $154.88 Typical High $223.87 | Professional | None | $109.65 | $154.88 | $223.87 |
CareFirst Setting Professional Modifier None Typical Low $109.65 Median $123.03 Typical High $2,511.89 | Professional | None | $109.65 | $123.03 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $177.83 Typical High $2,691.53 | Facility | None | $91.20 | $177.83 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $158.49 Typical High $251.19 | Professional | None | $109.65 | $158.49 | $251.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $97.72 Median $190.55 Typical High $234.42 | Professional | None | $97.72 | $190.55 | $234.42 |
Medcost Setting Professional Modifier None Typical Low $186.21 Median $234.42 Typical High $234.42 | Professional | None | $186.21 | $234.42 | $234.42 |
Medcost Setting Facility Modifier None Typical Low $125.89 Median $158.49 Typical High $251.19 | Facility | None | $125.89 | $158.49 | $251.19 |
Medcost Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Sentara Setting Facility Modifier None Typical Low $114.82 Median $912.01 Typical High $8,709.64 | Facility | None | $114.82 | $912.01 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $141.25 Median $186.21 Typical High $4,570.88 | Professional | None | $141.25 | $186.21 | $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 $100.00 Median $169.82 Typical High $263.03 | Professional | None | $100.00 | $169.82 | $263.03 |
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 $46.77 Median $67.61 Typical High $75.86 | Professional | 52 · Reduced service | $46.77 | $67.61 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $26.92 Typical High $30.90 | Professional | 53 · Discontinued | $18.62 | $26.92 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $102.33 Typical High $114.82 | Professional | 54 · Surgery only | $70.79 | $102.33 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $20.42 Typical High $22.91 | Professional | 55 · Aftercare only | $14.13 | $20.42 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $13.49 Typical High $15.14 | Professional | 56 · Pre-op care only | $9.33 | $13.49 | $15.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $66.07 Median $95.50 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $66.07 | $95.50 | $107.15 |
Where Virginia sits
The same service costs 3.6 times more in Wisconsin than in Texas. 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· 37th of 51
$162
WI $468TX $129
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.