How much rates vary
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 $1,659.59 Median $4,786.30 Typical High $14,125.38 | Facility | None | $1,659.59 | $4,786.30 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $2,754.23 | Professional | None | $1,621.81 | $1,621.81 | $2,754.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $12,589.25 Median $22,387.21 Typical High $38,018.94 | Facility | None | $12,589.25 | $22,387.21 | $38,018.94 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $1,445.44 | Professional | None | $1,047.13 | $1,230.27 | $1,445.44 |
CareFirst Setting Professional Modifier None Typical Low $1,737.80 Median $1,905.46 Typical High $2,238.72 | Professional | None | $1,737.80 | $1,905.46 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $11,481.54 Typical High $22,908.68 | Facility | None | $707.95 | $11,481.54 | $22,908.68 |
Cigna Setting Professional Modifier None Typical Low $7,079.46 Median $7,079.46 Typical High $7,079.46 | Professional | None | $7,079.46 | $7,079.46 | $7,079.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,412.54 Median $1,621.81 Typical High $2,041.74 | Professional | None | $1,412.54 | $1,621.81 | $2,041.74 |
Medcost Setting Facility Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $2,511.89 | Facility | None | $1,659.59 | $1,659.59 | $2,511.89 |
Medcost Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
Sentara Setting Facility Modifier None Typical Low $1,023.29 Median $6,025.60 Typical High $43,651.58 | Facility | None | $1,023.29 | $6,025.60 | $43,651.58 |
Sentara Setting Professional Modifier None Typical Low $1,412.54 Median $2,238.72 Typical High $43,651.58 | Professional | None | $1,412.54 | $2,238.72 | $43,651.58 |
United Setting Facility Modifier None Typical Low $10,000.00 Median $22,908.68 Typical High $64,565.42 | Facility | None | $10,000.00 | $22,908.68 | $64,565.42 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,348.96 Typical High $2,454.71 | Professional | None | $954.99 | $1,348.96 | $2,454.71 |
5 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 $776.25 Median $812.83 Typical High $831.76 | Professional | 52 · Reduced service | $776.25 | $812.83 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $323.59 Typical High $331.13 | Professional | 53 · Discontinued | $309.03 | $323.59 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,202.26 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,202.26 | $1,202.26 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $239.88 Typical High $245.47 | Professional | 55 · Aftercare only | $234.42 | $239.88 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $162.18 Typical High $165.96 | Professional | 56 · Pre-op care only | $154.88 | $162.18 | $165.96 |
Where Virginia sits
The same service costs 6.9 times more in Arkansas 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· 46th of 51
$1,380
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.