How much rates vary
Facilitymedian $1,230 · 10th to 90th $204 to $4,786Professionalmedian $182 · 10th to 90th $141 to $363
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 $251.19 Median $3,981.07 Typical High $9,332.54 | Facility | None | $251.19 | $3,981.07 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $234.42 Typical High $269.15 | Professional | None | $158.49 | $234.42 | $269.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $2,398.83 Typical High $2,951.21 | Facility | None | $1,698.24 | $2,398.83 | $2,951.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $144.54 Median $173.78 Typical High $208.93 | Professional | None | $144.54 | $173.78 | $208.93 |
CareFirst Setting Professional Modifier None Typical Low $154.88 Median $169.82 Typical High $223.87 | Professional | None | $154.88 | $169.82 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $602.56 Typical High $1,621.81 | Facility | None | $346.74 | $602.56 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $223.87 Typical High $371.54 | Professional | None | $144.54 | $223.87 | $371.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $245.47 Median $295.12 Typical High $363.08 | Professional | None | $245.47 | $295.12 | $363.08 |
Medcost Setting Professional Modifier None Typical Low $398.11 Median $501.19 Typical High $501.19 | Professional | None | $398.11 | $501.19 | $501.19 |
Medcost Setting Facility Modifier None Typical Low $177.83 Median $269.15 Typical High $446.68 | Facility | None | $177.83 | $269.15 | $446.68 |
Medcost Setting Professional Modifier None Typical Low $147.91 Median $177.83 Typical High $354.81 | Professional | None | $147.91 | $177.83 | $354.81 |
Sentara Setting Facility Modifier None Typical Low $138.04 Median $616.60 Typical High $2,951.21 | Facility | None | $138.04 | $616.60 | $2,951.21 |
Sentara Setting Professional Modifier None Typical Low $234.42 Median $338.84 Typical High $588.84 | Professional | None | $234.42 | $338.84 | $588.84 |
United Setting Facility Modifier None Typical Low $323.59 Median $1,445.44 Typical High $3,630.78 | Facility | None | $323.59 | $1,445.44 | $3,630.78 |
United Setting Professional Modifier None Typical Low $114.82 Median $213.80 Typical High $426.58 | Professional | None | $114.82 | $213.80 | $426.58 |
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 $79.43 Median $109.65 Typical High $134.90 | Professional | 52 · Reduced service | $79.43 | $109.65 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $43.65 Typical High $54.95 | Professional | 53 · Discontinued | $31.62 | $43.65 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $165.96 Typical High $204.17 | Professional | 54 · Surgery only | $120.23 | $165.96 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $33.11 Typical High $40.74 | Professional | 55 · Aftercare only | $23.99 | $33.11 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $21.88 Typical High $26.92 | Professional | 56 · Pre-op care only | $15.85 | $21.88 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $154.88 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $112.20 | $154.88 | $190.55 |
Where Virginia sits
The same service costs 4.2 times more in Alaska than in 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.
Virginia· 51st of 51
$186
AK $776VA $186
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.