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 $1,584.89 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,584.89 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,584.89 Typical High $1,621.81 | Professional | None | $1,380.38 | $1,584.89 | $1,621.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,964.78 Median $13,803.84 Typical High $15,848.93 | Facility | None | $10,964.78 | $13,803.84 | $15,848.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,230.27 Typical High $1,584.89 | Professional | None | $1,071.52 | $1,230.27 | $1,584.89 |
CareFirst Setting Professional Modifier None Typical Low $1,698.24 Median $1,905.46 Typical High $2,344.23 | Professional | None | $1,698.24 | $1,905.46 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,174.90 Typical High $6,025.60 | Facility | None | $501.19 | $1,174.90 | $6,025.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,380.38 Median $1,659.59 Typical High $2,041.74 | Professional | None | $1,380.38 | $1,659.59 | $2,041.74 |
Medcost Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $2,398.83 | Facility | None | $1,584.89 | $1,584.89 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
Sentara Setting Facility Modifier None Typical Low $1,258.93 Median $2,137.96 Typical High $8,709.64 | Facility | None | $1,258.93 | $2,137.96 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $1,348.96 Median $2,089.30 Typical High $9,332.54 | Professional | None | $1,348.96 | $2,089.30 | $9,332.54 |
United Setting Facility Modifier None Typical Low $436.52 Median $2,344.23 Typical High $6,309.57 | Facility | None | $436.52 | $2,344.23 | $6,309.57 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $2,089.30 Typical High $3,090.30 | Professional | None | $1,258.93 | $2,089.30 | $3,090.30 |
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 $660.69 Median $741.31 Typical High $794.33 | Professional | 52 · Reduced service | $660.69 | $741.31 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $295.12 Typical High $316.23 | Professional | 53 · Discontinued | $269.15 | $295.12 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,096.48 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,000.00 | $1,096.48 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $218.78 Typical High $234.42 | Professional | 55 · Aftercare only | $199.53 | $218.78 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $147.91 Typical High $158.49 | Professional | 56 · Pre-op care only | $134.90 | $147.91 | $158.49 |
Where Virginia sits
The same service costs 6.8 times more in Alaska than in Arkansas. 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· 38th of 51
$1,479
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.