How much rates vary
Facilitymedian $525 · 10th to 90th $93 to $3,802Professionalmedian $120 · 10th to 90th $91 to $186
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 $128.82 Median $3,801.89 Typical High $9,332.54 | Facility | None | $128.82 | $3,801.89 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $128.82 Typical High $229.09 | Professional | None | $89.13 | $128.82 | $229.09 |
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 $95.50 Median $112.20 Typical High $134.90 | Professional | None | $95.50 | $112.20 | $134.90 |
CareFirst Setting Professional Modifier None Typical Low $100.00 Median $112.20 Typical High $131.83 | Professional | None | $100.00 | $112.20 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $223.87 Typical High $1,621.81 | Facility | None | $83.18 | $223.87 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $120.23 Typical High $165.96 | Professional | None | $91.20 | $120.23 | $165.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $125.89 Median $147.91 Typical High $186.21 | Professional | None | $125.89 | $147.91 | $186.21 |
Medcost Setting Professional Modifier None Typical Low $154.88 Median $204.17 Typical High $204.17 | Professional | None | $154.88 | $204.17 | $204.17 |
Medcost Setting Facility Modifier None Typical Low $89.13 Median $125.89 Typical High $234.42 | Facility | None | $89.13 | $125.89 | $234.42 |
Medcost Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
Sentara Setting Facility Modifier None Typical Low $91.20 Median $371.54 Typical High $2,454.71 | Facility | None | $91.20 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $123.03 Median $154.88 Typical High $870.96 | Professional | None | $123.03 | $154.88 | $870.96 |
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 $77.62 Median $114.82 Typical High $199.53 | Professional | None | $77.62 | $114.82 | $199.53 |
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 $44.67 Median $64.57 Typical High $83.18 | Professional | 52 · Reduced service | $44.67 | $64.57 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $25.70 Typical High $33.11 | Professional | 53 · Discontinued | $17.78 | $25.70 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $97.72 Typical High $125.89 | Professional | 54 · Surgery only | $66.07 | $97.72 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $19.50 Typical High $25.12 | Professional | 55 · Aftercare only | $13.18 | $19.50 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $12.88 Typical High $16.60 | Professional | 56 · Pre-op care only | $8.91 | $12.88 | $16.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $91.20 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $61.66 | $91.20 | $117.49 |
Where Virginia sits
The same service costs 4.0 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· 41st of 51
$123
AK $407FL $102
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.