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 $575.44 Median $5,370.32 Typical High $14,125.38 | Facility | None | $575.44 | $5,370.32 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $2,041.74 | Professional | None | $407.38 | $407.38 | $2,041.74 |
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 $954.99 Median $1,122.02 Typical High $1,258.93 | Professional | None | $954.99 | $1,122.02 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $794.33 Typical High $3,019.95 | Facility | None | $512.86 | $794.33 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,621.81 | $1,621.81 | $1,621.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $323.59 Median $380.19 Typical High $467.74 | Professional | None | $323.59 | $380.19 | $467.74 |
Medcost Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $870.96 | Facility | None | $575.44 | $575.44 | $870.96 |
Medcost Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
Sentara Setting Facility Modifier None Typical Low $407.38 Median $2,570.40 Typical High $11,481.54 | Facility | None | $407.38 | $2,570.40 | $11,481.54 |
Sentara Setting Professional Modifier None Typical Low $371.54 Median $616.60 Typical High $11,481.54 | Professional | None | $371.54 | $616.60 | $11,481.54 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $8,511.38 Typical High $20,417.38 | Facility | None | $1,995.26 | $8,511.38 | $20,417.38 |
United Setting Professional Modifier None Typical Low $218.78 Median $302.00 Typical High $602.56 | Professional | None | $218.78 | $302.00 | $602.56 |
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 $199.53 Median $199.53 Typical High $288.40 | Professional | 52 · Reduced service | $199.53 | $199.53 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $114.82 | Professional | 53 · Discontinued | $81.28 | $81.28 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $302.00 Typical High $426.58 | Professional | 54 · Surgery only | $302.00 | $302.00 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $87.10 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $57.54 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $57.54 |
Where Virginia sits
The same service costs 7.8 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· 14th of 51
$1,096
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.