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 $323.59 Median $4,365.16 Typical High $14,125.38 | Facility | None | $323.59 | $4,365.16 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $309.03 Typical High $2,041.74 | Professional | None | $173.78 | $309.03 | $2,041.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $2,398.83 Typical High $2,951.21 | Facility | None | $1,698.24 | $2,398.83 | $2,951.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $380.19 Median $446.68 Typical High $549.54 | Professional | None | $380.19 | $446.68 | $549.54 |
CareFirst Setting Professional Modifier None Typical Low $338.84 Median $380.19 Typical High $380.19 | Professional | None | $338.84 | $380.19 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $630.96 Typical High $1,659.59 | Facility | None | $389.05 | $630.96 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,548.82 | $1,548.82 | $1,548.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $295.12 Median $363.08 Typical High $426.58 | Professional | None | $295.12 | $363.08 | $426.58 |
Medcost Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $263.03 | Facility | None | $173.78 | $173.78 | $263.03 |
Sentara Setting Facility Modifier None Typical Low $309.03 Median $758.58 Typical High $4,570.88 | Facility | None | $309.03 | $758.58 | $4,570.88 |
Sentara Setting Professional Modifier None Typical Low $208.93 Median $478.63 Typical High $1,737.80 | Professional | None | $208.93 | $478.63 | $1,737.80 |
United Setting Facility Modifier None Typical Low $323.59 Median $1,445.44 Typical High $3,630.78 | Facility | None | $323.59 | $1,445.44 | $3,630.78 |
United Setting Professional Modifier None Typical Low $147.91 Median $295.12 Typical High $588.84 | Professional | None | $147.91 | $295.12 | $588.84 |
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 $87.10 Median $144.54 Typical High $162.18 | Professional | 52 · Reduced service | $87.10 | $144.54 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $57.54 Typical High $64.57 | Professional | 53 · Discontinued | $34.67 | $57.54 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $213.80 Typical High $245.47 | Professional | 54 · Surgery only | $131.83 | $213.80 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $42.66 Typical High $48.98 | Professional | 55 · Aftercare only | $26.30 | $42.66 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $28.84 Typical High $32.36 | Professional | 56 · Pre-op care only | $17.38 | $28.84 | $32.36 |
Where Virginia sits
The same service costs 8.3 times more in Oklahoma than in Rhode Island. 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· 25th of 51
$427
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.