How much rates vary
Facilitymedian $1,698 · 10th to 90th $126 to $5,754Professionalmedian $126 · 10th to 90th $87 to $324
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 $4,073.80 Typical High $10,000.00 | Facility | None | $125.89 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $199.53 Typical High $323.59 | Professional | None | $83.18 | $199.53 | $323.59 |
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 $91.20 Median $112.20 Typical High $128.82 | Professional | None | $91.20 | $112.20 | $128.82 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $138.04 Median $165.96 Typical High $194.98 | Professional | 50 · Both sides | $138.04 | $165.96 | $194.98 |
CareFirst Setting Professional Modifier None Typical Low $97.72 Median $107.15 Typical High $125.89 | Professional | None | $97.72 | $107.15 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $389.05 Typical High $1,621.81 | Facility | None | $204.17 | $389.05 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $204.17 Typical High $295.12 | Professional | None | $87.10 | $204.17 | $295.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $234.42 Median $275.42 Typical High $346.74 | Professional | None | $234.42 | $275.42 | $346.74 |
Medcost Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $323.59 | Professional | None | $316.23 | $316.23 | $323.59 |
Medcost Setting Facility Modifier None Typical Low $83.18 Median $177.83 Typical High $416.87 | Facility | None | $83.18 | $177.83 | $416.87 |
Medcost Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
Sentara Setting Facility Modifier None Typical Low $83.18 Median $870.96 Typical High $3,630.78 | Facility | None | $83.18 | $870.96 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $223.87 Median $302.00 Typical High $2,137.96 | Professional | None | $223.87 | $302.00 | $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 $74.13 Median $165.96 Typical High $338.84 | Professional | None | $74.13 | $165.96 | $338.84 |
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 $41.69 Median $91.20 Typical High $162.18 | Professional | 52 · Reduced service | $41.69 | $91.20 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $37.15 Typical High $66.07 | Professional | 53 · Discontinued | $16.98 | $37.15 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $138.04 Typical High $245.47 | Professional | 54 · Surgery only | $63.10 | $138.04 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $27.54 Typical High $48.98 | Professional | 55 · Aftercare only | $12.59 | $27.54 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $18.20 Typical High $32.36 | Professional | 56 · Pre-op care only | $8.32 | $18.20 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $58.88 Median $128.82 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $58.88 | $128.82 | $229.09 |
Where Virginia sits
The same service costs 5.6 times more in Alaska than in Kentucky. 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· 50th of 51
$129
AK $562KY $100
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.