How much rates vary
Facilitymedian $589 · 10th to 90th $98 to $4,074Professionalmedian $138 · 10th to 90th $105 to $219
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 $4,073.80 Typical High $10,000.00 | Facility | None | $128.82 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $151.36 Typical High $263.03 | Professional | None | $102.33 | $151.36 | $263.03 |
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 $109.65 Median $128.82 Typical High $154.88 | Professional | None | $109.65 | $128.82 | $154.88 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $162.18 Median $194.98 Typical High $229.09 | Professional | 50 · Both sides | $162.18 | $194.98 | $229.09 |
CareFirst Setting Professional Modifier None Typical Low $114.82 Median $128.82 Typical High $151.36 | Professional | None | $114.82 | $128.82 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $100.00 Typical High $186.21 | Facility | None | $50.12 | $100.00 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $134.90 Typical High $190.55 | Professional | None | $107.15 | $134.90 | $190.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $138.04 Median $162.18 Typical High $204.17 | Professional | None | $138.04 | $162.18 | $204.17 |
Medcost Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $257.04 | Professional | None | $251.19 | $251.19 | $257.04 |
Medcost Setting Facility Modifier None Typical Low $102.33 Median $141.25 Typical High $269.15 | Facility | None | $102.33 | $141.25 | $269.15 |
Medcost Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
Sentara Setting Facility Modifier None Typical Low $100.00 Median $371.54 Typical High $2,454.71 | Facility | None | $100.00 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $141.25 Median $177.83 Typical High $870.96 | Professional | None | $141.25 | $177.83 | $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 $89.13 Median $131.83 Typical High $234.42 | Professional | None | $89.13 | $131.83 | $234.42 |
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 $51.29 Median $74.13 Typical High $95.50 | Professional | 52 · Reduced service | $51.29 | $74.13 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $30.20 Typical High $38.02 | Professional | 53 · Discontinued | $20.42 | $30.20 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $112.20 Typical High $141.25 | Professional | 54 · Surgery only | $75.86 | $112.20 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $22.39 Typical High $28.84 | Professional | 55 · Aftercare only | $15.14 | $22.39 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $15.14 Typical High $19.05 | Professional | 56 · Pre-op care only | $10.23 | $15.14 | $19.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $104.71 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $70.79 | $104.71 | $131.83 |
Where Virginia sits
The same service costs 4.1 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
$141
AK $468FL $115
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.