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 $524.81 Median $5,888.44 Typical High $14,125.38 | Facility | None | $524.81 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $512.86 Typical High $5,370.32 | Professional | None | $489.78 | $512.86 | $5,370.32 |
Anthem BCBS Setting Facility Modifier None Typical Low $12,589.25 Median $22,387.21 Typical High $38,018.94 | Facility | None | $12,589.25 | $22,387.21 | $38,018.94 |
Anthem BCBS Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $977.24 | Professional | None | $331.13 | $331.13 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $17,782.79 Typical High $36,307.81 | Facility | None | $512.86 | $17,782.79 | $36,307.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $616.60 Median $741.31 Typical High $912.01 | Professional | None | $616.60 | $741.31 | $912.01 |
Medcost Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $776.25 | Facility | None | $512.86 | $512.86 | $776.25 |
Medcost Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
Sentara Setting Facility Modifier None Typical Low $630.96 Median $7,413.10 Typical High $51,286.14 | Facility | None | $630.96 | $7,413.10 | $51,286.14 |
Sentara Setting Professional Modifier None Typical Low $562.34 Median $954.99 Typical High $46,773.51 | Professional | None | $562.34 | $954.99 | $46,773.51 |
United Setting Facility Modifier None Typical Low $16,982.44 Median $35,481.34 Typical High $89,125.09 | Facility | None | $16,982.44 | $35,481.34 | $89,125.09 |
United Setting Professional Modifier None Typical Low $446.68 Median $724.44 Typical High $1,122.02 | Professional | None | $446.68 | $724.44 | $1,122.02 |
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 $239.88 Median $257.04 Typical High $263.03 | Professional | 52 · Reduced service | $239.88 | $257.04 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $102.33 Typical High $104.71 | Professional | 53 · Discontinued | $95.50 | $102.33 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $380.19 Typical High $389.05 | Professional | 54 · Surgery only | $354.81 | $380.19 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $75.86 Typical High $79.43 | Professional | 55 · Aftercare only | $70.79 | $75.86 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $51.29 Typical High $52.48 | Professional | 56 · Pre-op care only | $47.86 | $51.29 | $52.48 |
Where Virginia sits
The same service costs 29.5 times more in Louisiana than in Maine. 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· 17th of 51
$2,455
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.