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 $489.78 Median $4,786.30 Typical High $14,125.38 | Facility | None | $489.78 | $4,786.30 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $489.78 Typical High $3,981.07 | Professional | None | $380.19 | $489.78 | $3,981.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $3,715.35 Typical High $4,265.80 | Facility | None | $2,884.03 | $3,715.35 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $870.96 | Professional | None | $263.03 | $263.03 | $870.96 |
CareFirst Setting Professional Modifier None Typical Low $2,290.87 Median $2,691.53 Typical High $3,548.13 | Professional | None | $2,290.87 | $2,691.53 | $3,548.13 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,288.25 Typical High $3,548.13 | Facility | None | $524.81 | $1,288.25 | $3,548.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $338.84 Median $407.38 Typical High $501.19 | Professional | None | $338.84 | $407.38 | $501.19 |
Medcost Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $741.31 | Facility | None | $489.78 | $489.78 | $741.31 |
Medcost Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
Sentara Setting Facility Modifier None Typical Low $426.58 Median $1,047.13 Typical High $3,715.35 | Facility | None | $426.58 | $1,047.13 | $3,715.35 |
Sentara Setting Professional Modifier None Typical Low $407.38 Median $575.44 Typical High $3,630.78 | Professional | None | $407.38 | $575.44 | $3,630.78 |
United Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $5,888.44 | Facility | None | $588.84 | $2,187.76 | $5,888.44 |
United Setting Professional Modifier None Typical Low $398.11 Median $645.65 Typical High $1,000.00 | Professional | None | $398.11 | $645.65 | $1,000.00 |
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 $190.55 Median $213.80 Typical High $245.47 | Professional | 52 · Reduced service | $190.55 | $213.80 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $85.11 Typical High $97.72 | Professional | 53 · Discontinued | $75.86 | $85.11 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $323.59 Typical High $363.08 | Professional | 54 · Surgery only | $288.40 | $323.59 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $64.57 Typical High $72.44 | Professional | 55 · Aftercare only | $57.54 | $64.57 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $42.66 Typical High $48.98 | Professional | 56 · Pre-op care only | $38.02 | $42.66 | $48.98 |
Where Virginia sits
The same service costs 8.1 times more in Texas 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· 26th of 51
$813
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.