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 $870.96 Median $5,370.32 Typical High $14,125.38 | Facility | None | $870.96 | $5,370.32 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $870.96 Typical High $1,905.46 | Professional | None | $812.83 | $870.96 | $1,905.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $7,413.10 Typical High $9,549.93 | Facility | None | $6,165.95 | $7,413.10 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $616.60 Median $707.95 Typical High $851.14 | Professional | None | $616.60 | $707.95 | $851.14 |
CareFirst Setting Professional Modifier None Typical Low $831.76 Median $933.25 Typical High $933.25 | Professional | None | $831.76 | $933.25 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $3,801.89 Typical High $7,585.78 | Facility | None | $512.86 | $3,801.89 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $3,801.89 | Professional | None | $3,801.89 | $3,801.89 | $3,801.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $1,122.02 | Professional | None | $758.58 | $891.25 | $1,122.02 |
Medcost Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $1,230.27 | Facility | None | $812.83 | $812.83 | $1,230.27 |
Medcost Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
Sentara Setting Facility Modifier None Typical Low $691.83 Median $2,454.71 Typical High $11,481.54 | Facility | None | $691.83 | $2,454.71 | $11,481.54 |
Sentara Setting Professional Modifier None Typical Low $724.44 Median $933.25 Typical High $10,232.93 | Professional | None | $724.44 | $933.25 | $10,232.93 |
United Setting Facility Modifier None Typical Low $2,137.96 Median $8,511.38 Typical High $20,417.38 | Facility | None | $2,137.96 | $8,511.38 | $20,417.38 |
United Setting Professional Modifier None Typical Low $575.44 Median $776.25 Typical High $1,258.93 | Professional | None | $575.44 | $776.25 | $1,258.93 |
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 $407.38 Median $416.87 Typical High $436.52 | Professional | 52 · Reduced service | $407.38 | $416.87 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $165.96 Typical High $173.78 | Professional | 53 · Discontinued | $162.18 | $165.96 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $616.60 Typical High $645.65 | Professional | 54 · Surgery only | $602.56 | $616.60 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $125.89 Typical High $128.82 | Professional | 55 · Aftercare only | $120.23 | $125.89 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $85.11 Typical High $87.10 | Professional | 56 · Pre-op care only | $81.28 | $85.11 | $87.10 |
Where Virginia sits
The same service costs 5.1 times more in Texas than in Delaware. 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· 45th 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.