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 $436.52 Median $5,888.44 Typical High $14,125.38 | Facility | None | $436.52 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $407.38 Typical High $5,370.32 | Professional | None | $323.59 | $407.38 | $5,370.32 |
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 $288.40 Median $288.40 Typical High $630.96 | Professional | None | $288.40 | $288.40 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $7,079.46 Typical High $14,454.40 | Facility | None | $512.86 | $7,079.46 | $14,454.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $501.19 Typical High $616.60 | Professional | None | $416.87 | $501.19 | $616.60 |
Medcost Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $489.78 | Facility | None | $323.59 | $323.59 | $489.78 |
Medcost Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
Sentara Setting Facility Modifier None Typical Low $416.87 Median $3,981.07 Typical High $19,952.62 | Facility | None | $416.87 | $3,981.07 | $19,952.62 |
Sentara Setting Professional Modifier None Typical Low $380.19 Median $707.95 Typical High $21,379.62 | Professional | None | $380.19 | $707.95 | $21,379.62 |
United Setting Facility Modifier None Typical Low $4,570.88 Median $13,489.63 Typical High $36,307.81 | Facility | None | $4,570.88 | $13,489.63 | $36,307.81 |
United Setting Professional Modifier None Typical Low $281.84 Median $467.74 Typical High $707.95 | Professional | None | $281.84 | $467.74 | $707.95 |
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 $162.18 Median $177.83 Typical High $218.78 | Professional | 52 · Reduced service | $162.18 | $177.83 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $70.79 Typical High $87.10 | Professional | 53 · Discontinued | $64.57 | $70.79 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $269.15 Typical High $331.13 | Professional | 54 · Surgery only | $245.47 | $269.15 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $53.70 Typical High $66.07 | Professional | 55 · Aftercare only | $48.98 | $53.70 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $35.48 Typical High $43.65 | Professional | 56 · Pre-op care only | $32.36 | $35.48 | $43.65 |
Where Virginia sits
The same service costs 16.2 times more in Arkansas than in West Virginia. 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· 19th of 51
$1,660
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.