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 $263.03 Median $5,370.32 Typical High $14,125.38 | Facility | None | $263.03 | $5,370.32 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $218.78 Typical High $1,230.27 | Professional | None | $194.98 | $218.78 | $1,230.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $44.67 Median $57.54 Typical High $104.71 | Professional | None | $44.67 | $57.54 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,230.27 Typical High $3,019.95 | Facility | None | $512.86 | $1,230.27 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | None | $776.25 | $776.25 | $776.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $181.97 Typical High $229.09 | Professional | None | $154.88 | $181.97 | $229.09 |
Medcost Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $398.11 | Facility | None | $263.03 | $263.03 | $398.11 |
Medcost Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
Sentara Setting Facility Modifier None Typical Low $213.80 Median $416.87 Typical High $2,454.71 | Facility | None | $213.80 | $416.87 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $218.78 Median $275.42 Typical High $1,148.15 | Professional | None | $218.78 | $275.42 | $1,148.15 |
United Setting Facility Modifier None Typical Low $100.00 Median $660.69 Typical High $2,089.30 | Facility | None | $100.00 | $660.69 | $2,089.30 |
United Setting Professional Modifier None Typical Low $177.83 Median $245.47 Typical High $398.11 | Professional | None | $177.83 | $245.47 | $398.11 |
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 $97.72 Median $97.72 Typical High $131.83 | Professional | 52 · Reduced service | $97.72 | $97.72 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $52.48 | Professional | 53 · Discontinued | $38.90 | $38.90 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $147.91 Typical High $194.98 | Professional | 54 · Surgery only | $147.91 | $147.91 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $29.51 Typical High $38.90 | Professional | 55 · Aftercare only | $29.51 | $29.51 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.50 Typical High $26.30 | Professional | 56 · Pre-op care only | $19.50 | $19.50 | $26.30 |
Where Virginia sits
The same service costs 18.6 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· 20th of 51
$275
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.