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 $398.11 Median $7,762.47 Typical High $15,488.17 | Facility | None | $398.11 | $7,762.47 | $15,488.17 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $398.11 Typical High $7,079.46 | Professional | None | $354.81 | $398.11 | $7,079.46 |
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 $309.03 Median $354.81 Typical High $457.09 | Professional | None | $309.03 | $354.81 | $457.09 |
CareFirst Setting Professional Modifier None Typical Low $13,489.63 Median $19,952.62 Typical High $25,703.96 | Professional | None | $13,489.63 | $19,952.62 | $25,703.96 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $18,620.87 Typical High $37,153.52 | Facility | None | $512.86 | $18,620.87 | $37,153.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $331.13 Median $389.05 Typical High $489.78 | Professional | None | $331.13 | $389.05 | $489.78 |
Medcost Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $602.56 | Facility | None | $398.11 | $398.11 | $602.56 |
Medcost Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
Sentara Setting Facility Modifier None Typical Low $354.81 Median $954.99 Typical High $38,904.51 | Facility | None | $354.81 | $954.99 | $38,904.51 |
Sentara Setting Professional Modifier None Typical Low $363.08 Median $478.63 Typical High $11,481.54 | Professional | None | $363.08 | $478.63 | $11,481.54 |
United Setting Facility Modifier None Typical Low $16,982.44 Median $35,481.34 Typical High $89,125.09 | Facility | None | $16,982.44 | $35,481.34 | $89,125.09 |
United Setting Professional Modifier None Typical Low $331.13 Median $537.03 Typical High $812.83 | Professional | None | $331.13 | $537.03 | $812.83 |
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 $173.78 Median $199.53 Typical High $199.53 | Professional | 52 · Reduced service | $173.78 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $79.43 Typical High $81.28 | Professional | 53 · Discontinued | $69.18 | $79.43 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $302.00 Typical High $302.00 | Professional | 54 · Surgery only | $263.03 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $60.26 Typical High $60.26 | Professional | 55 · Aftercare only | $52.48 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $39.81 Typical High $39.81 | Professional | 56 · Pre-op care only | $34.67 | $39.81 | $39.81 |
Where Virginia sits
The same service costs 63.1 times more in Arkansas than in New York. 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· 48th of 51
$427
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.