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 $3,235.94 Median $8,317.64 Typical High $19,054.61 | Facility | None | $3,235.94 | $8,317.64 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $354.81 Typical High $8,317.64 | Professional | None | $54.95 | $354.81 | $8,317.64 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,964.78 Median $13,803.84 Typical High $15,848.93 | Facility | None | $10,964.78 | $13,803.84 | $15,848.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $309.03 Median $354.81 Typical High $446.68 | Professional | None | $309.03 | $354.81 | $446.68 |
CareFirst Setting Professional Modifier None Typical Low $10,715.19 Median $12,589.25 Typical High $14,454.40 | Professional | None | $10,715.19 | $12,589.25 | $14,454.40 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $6,760.83 Typical High $13,489.63 | Facility | None | $512.86 | $6,760.83 | $13,489.63 |
Kaiser Permanente Setting Professional Modifier None Typical Low $331.13 Median $398.11 Typical High $489.78 | Professional | None | $331.13 | $398.11 | $489.78 |
Medcost Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $85.11 | Facility | None | $54.95 | $54.95 | $85.11 |
Medcost Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
Sentara Setting Facility Modifier None Typical Low $50.12 Median $616.60 Typical High $18,620.87 | Facility | None | $50.12 | $616.60 | $18,620.87 |
Sentara Setting Professional Modifier None Typical Low $51.29 Median $72.44 Typical High $11,481.54 | Professional | None | $51.29 | $72.44 | $11,481.54 |
United Setting Facility Modifier None Typical Low $4,570.88 Median $13,489.63 Typical High $36,307.81 | Facility | None | $4,570.88 | $13,489.63 | $36,307.81 |
United Setting Professional Modifier None Typical Low $45.71 Median $75.86 Typical High $114.82 | Professional | None | $45.71 | $75.86 | $114.82 |
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 $27.54 Median $27.54 Typical High $177.83 | Professional | 52 · Reduced service | $27.54 | $27.54 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $10.96 Typical High $70.79 | Professional | 53 · Discontinued | $10.96 | $10.96 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $41.69 Typical High $269.15 | Professional | 54 · Surgery only | $41.69 | $41.69 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.32 Typical High $53.70 | Professional | 55 · Aftercare only | $8.32 | $8.32 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.50 Typical High $35.48 | Professional | 56 · Pre-op care only | $5.50 | $5.50 | $35.48 |
Where Virginia sits
The same service costs 93.3 times more in Oregon than in Vermont. 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· 39th of 51
$363
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.