How much rates vary
Facilitymedian $2,291 · 10th to 90th $275 to $9,120Professionalmedian $302 · 10th to 90th $224 to $457
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 $257.04 Median $467.74 Typical High $8,317.64 | Facility | None | $257.04 | $467.74 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $302.00 Typical High $512.86 | Professional | None | $194.98 | $302.00 | $512.86 |
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 $234.42 Median $295.12 Typical High $398.11 | Professional | None | $234.42 | $295.12 | $398.11 |
CareFirst Setting Professional Modifier None Typical Low $229.09 Median $257.04 Typical High $2,511.89 | Professional | None | $229.09 | $257.04 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,737.80 Typical High $3,311.31 | Facility | None | $478.63 | $1,737.80 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $288.40 Typical High $446.68 | Professional | None | $223.87 | $288.40 | $446.68 |
Kaiser Permanente Setting Professional Modifier None Typical Low $204.17 Median $346.74 Typical High $426.58 | Professional | None | $204.17 | $346.74 | $426.58 |
Medcost Setting Professional Modifier None Typical Low $302.00 Median $380.19 Typical High $380.19 | Professional | None | $302.00 | $380.19 | $380.19 |
Medcost Setting Facility Modifier None Typical Low $251.19 Median $302.00 Typical High $489.78 | Facility | None | $251.19 | $302.00 | $489.78 |
Medcost Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
Sentara Setting Facility Modifier None Typical Low $199.53 Median $1,023.29 Typical High $8,709.64 | Facility | None | $199.53 | $1,023.29 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $251.19 Median $354.81 Typical High $4,073.80 | Professional | None | $251.19 | $354.81 | $4,073.80 |
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 $190.55 Median $309.03 Typical High $512.86 | Professional | None | $190.55 | $309.03 | $512.86 |
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 $97.72 Median $128.82 Typical High $151.36 | Professional | 52 · Reduced service | $97.72 | $128.82 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $51.29 Typical High $60.26 | Professional | 53 · Discontinued | $38.90 | $51.29 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $190.55 Typical High $223.87 | Professional | 54 · Surgery only | $147.91 | $190.55 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $38.02 Typical High $44.67 | Professional | 55 · Aftercare only | $29.51 | $38.02 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $25.70 Typical High $30.20 | Professional | 56 · Pre-op care only | $19.50 | $25.70 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $177.83 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $138.04 | $177.83 | $208.93 |
Where Virginia sits
The same service costs 8.5 times more in Alaska than in West Virginia. 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.
Physician feeFacility fee
AK $5,029WV $590
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.