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 $549.54 Median $5,370.32 Typical High $14,125.38 | Facility | None | $549.54 | $5,370.32 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $549.54 Typical High $549.54 | Professional | None | $524.81 | $549.54 | $549.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,772.37 Median $12,022.64 Typical High $15,848.93 | Facility | None | $9,772.37 | $12,022.64 | $15,848.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $912.01 | Professional | None | $630.96 | $741.31 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $4,677.35 Typical High $9,332.54 | Facility | None | $512.86 | $4,677.35 | $9,332.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $489.78 Median $588.84 Typical High $724.44 | Professional | None | $489.78 | $588.84 | $724.44 |
Medcost Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $831.76 | Facility | None | $549.54 | $549.54 | $831.76 |
Medcost Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
Sentara Setting Facility Modifier None Typical Low $489.78 Median $1,318.26 Typical High $8,709.64 | Facility | None | $489.78 | $1,318.26 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $489.78 Median $645.65 Typical High $1,288.25 | Professional | None | $489.78 | $645.65 | $1,288.25 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,011.87 Typical High $13,489.63 | Facility | None | $1,230.27 | $5,011.87 | $13,489.63 |
United Setting Professional Modifier None Typical Low $346.74 Median $489.78 Typical High $933.25 | Professional | None | $346.74 | $489.78 | $933.25 |
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 $245.47 Median $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $245.47 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $97.72 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $407.38 Typical High $407.38 | Professional | 54 · Surgery only | $371.54 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $74.13 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $48.98 | $54.95 | $54.95 |
Where Virginia sits
The same service costs 7.2 times more in Texas than in Pennsylvania. 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· 30th of 51
$741
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.