How much rates vary
Facilitymedian $1,698 · 10th to 90th $191 to $5,754Professionalmedian $191 · 10th to 90th $148 to $295
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 $3,981.07 Typical High $9,332.54 | Facility | None | $190.55 | $3,981.07 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $181.97 Typical High $229.09 | Professional | None | $162.18 | $181.97 | $229.09 |
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 $151.36 Median $177.83 Typical High $229.09 | Professional | None | $151.36 | $177.83 | $229.09 |
CareFirst Setting Professional Modifier None Typical Low $165.96 Median $186.21 Typical High $1,659.59 | Professional | None | $165.96 | $186.21 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $741.31 Typical High $1,659.59 | Facility | None | $346.74 | $741.31 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $190.55 Typical High $288.40 | Professional | None | $158.49 | $190.55 | $288.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $141.25 Median $218.78 Typical High $269.15 | Professional | None | $141.25 | $218.78 | $269.15 |
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 $169.82 Median $190.55 Typical High $309.03 | Facility | None | $169.82 | $190.55 | $309.03 |
Medcost Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
Sentara Setting Facility Modifier None Typical Low $131.83 Median $891.25 Typical High $3,630.78 | Facility | None | $131.83 | $891.25 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $154.88 Median $218.78 Typical High $2,137.96 | Professional | None | $154.88 | $218.78 | $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 $125.89 Median $199.53 Typical High $316.23 | Professional | None | $125.89 | $199.53 | $316.23 |
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 $81.28 Median $85.11 Typical High $97.72 | Professional | 52 · Reduced service | $81.28 | $85.11 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $33.88 Typical High $38.90 | Professional | 53 · Discontinued | $32.36 | $33.88 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $128.82 Typical High $144.54 | Professional | 54 · Surgery only | $123.03 | $128.82 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $25.70 Typical High $28.84 | Professional | 55 · Aftercare only | $24.55 | $25.70 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.98 Typical High $19.50 | Professional | 56 · Pre-op care only | $16.22 | $16.98 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $120.23 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $114.82 | $120.23 | $134.90 |
Where Virginia sits
The same service costs 4.6 times more in Alaska 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
$191
AK $759UT $166
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.