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 $446.68 Median $7,762.47 Typical High $15,488.17 | Facility | None | $446.68 | $7,762.47 | $15,488.17 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $446.68 Typical High $7,079.46 | Professional | None | $398.11 | $446.68 | $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 $239.88 Median $239.88 Typical High $794.33 | Professional | None | $239.88 | $239.88 | $794.33 |
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 $17,782.79 Typical High $36,307.81 | Facility | None | $512.86 | $17,782.79 | $36,307.81 |
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 $446.68 Median $446.68 Typical High $676.08 | Facility | None | $446.68 | $446.68 | $676.08 |
Medcost Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
Sentara Setting Facility Modifier None Typical Low $398.11 Median $1,023.29 Typical High $38,904.51 | Facility | None | $398.11 | $1,023.29 | $38,904.51 |
Sentara Setting Professional Modifier None Typical Low $398.11 Median $524.81 Typical High $11,481.54 | Professional | None | $398.11 | $524.81 | $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 $363.08 Median $588.84 Typical High $912.01 | Professional | None | $363.08 | $588.84 | $912.01 |
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 $194.98 Median $213.80 Typical High $223.87 | Professional | 52 · Reduced service | $194.98 | $213.80 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $85.11 Typical High $89.13 | Professional | 53 · Discontinued | $77.62 | $85.11 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $316.23 Typical High $331.13 | Professional | 54 · Surgery only | $288.40 | $316.23 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $64.57 Typical High $66.07 | Professional | 55 · Aftercare only | $57.54 | $64.57 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $42.66 Typical High $44.67 | Professional | 56 · Pre-op care only | $38.90 | $42.66 | $44.67 |
Where Virginia sits
The same service costs 57.5 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· 31st of 51
$933
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.