How much rates vary
Facilitymedian $501 · 10th to 90th $93 to $3,802Professionalmedian $145 · 10th to 90th $115 to $224
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 $162.18 Median $2,041.74 Typical High $9,332.54 | Facility | None | $162.18 | $2,041.74 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $162.18 Typical High $245.47 | Professional | None | $125.89 | $162.18 | $245.47 |
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 $114.82 Median $138.04 Typical High $165.96 | Professional | None | $114.82 | $138.04 | $165.96 |
CareFirst Setting Professional Modifier None Typical Low $123.03 Median $138.04 Typical High $162.18 | Professional | None | $123.03 | $138.04 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $89.13 Typical High $794.33 | Facility | None | $50.12 | $89.13 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $223.87 | Professional | None | $117.49 | $147.91 | $223.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $147.91 Median $177.83 Typical High $229.09 | Professional | None | $147.91 | $177.83 | $229.09 |
Medcost Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
Medcost Setting Facility Modifier None Typical Low $138.04 Median $169.82 Typical High $269.15 | Facility | None | $138.04 | $169.82 | $269.15 |
Medcost Setting Professional Modifier None Typical Low $64.57 Median $85.11 Typical High $186.21 | Professional | None | $64.57 | $85.11 | $186.21 |
Sentara Setting Facility Modifier None Typical Low $123.03 Median $371.54 Typical High $2,454.71 | Facility | None | $123.03 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $151.36 Median $177.83 Typical High $363.08 | Professional | None | $151.36 | $177.83 | $363.08 |
United Setting Facility Modifier None Typical Low $100.00 Median $660.69 Typical High $2,041.74 | Facility | None | $100.00 | $660.69 | $2,041.74 |
United Setting Professional Modifier None Typical Low $89.13 Median $134.90 Typical High $263.03 | Professional | None | $89.13 | $134.90 | $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 $63.10 Median $72.44 Typical High $83.18 | Professional | 52 · Reduced service | $63.10 | $72.44 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $29.51 Typical High $33.11 | Professional | 53 · Discontinued | $25.12 | $29.51 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $107.15 Typical High $125.89 | Professional | 54 · Surgery only | $95.50 | $107.15 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $21.88 Typical High $25.12 | Professional | 55 · Aftercare only | $19.05 | $21.88 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $14.79 Typical High $16.60 | Professional | 56 · Pre-op care only | $12.59 | $14.79 | $16.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $102.33 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $89.13 | $102.33 | $117.49 |
Where Virginia sits
The same service costs 3.9 times more in Alaska than in Florida. 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
$145
AK $501FL $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.