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 $257.04 Median $5,888.44 Typical High $14,125.38 | Facility | None | $257.04 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $239.88 Typical High $5,370.32 | Professional | None | $234.42 | $239.88 | $5,370.32 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $6,456.54 Typical High $7,244.36 | Facility | None | $4,677.35 | $6,456.54 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $457.09 | Professional | None | $125.89 | $125.89 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $2,187.76 Typical High $3,981.07 | Facility | None | $512.86 | $2,187.76 | $3,981.07 |
Kaiser Permanente Setting Professional Modifier None Typical Low $239.88 Median $288.40 Typical High $354.81 | Professional | None | $239.88 | $288.40 | $354.81 |
Medcost Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $363.08 | Facility | None | $239.88 | $239.88 | $363.08 |
Medcost Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Sentara Setting Facility Modifier None Typical Low $302.00 Median $2,238.72 Typical High $10,232.93 | Facility | None | $302.00 | $2,238.72 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $263.03 Median $446.68 Typical High $10,964.78 | Professional | None | $263.03 | $446.68 | $10,964.78 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $6,760.83 Typical High $17,378.01 | Facility | None | $1,548.82 | $6,760.83 | $17,378.01 |
United Setting Professional Modifier None Typical Low $208.93 Median $338.84 Typical High $524.81 | Professional | None | $208.93 | $338.84 | $524.81 |
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 $117.49 Median $120.23 Typical High $128.82 | Professional | 52 · Reduced service | $117.49 | $120.23 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $47.86 Typical High $51.29 | Professional | 53 · Discontinued | $46.77 | $47.86 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $177.83 Typical High $194.98 | Professional | 54 · Surgery only | $173.78 | $177.83 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $35.48 Typical High $38.90 | Professional | 55 · Aftercare only | $35.48 | $35.48 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.99 Typical High $25.70 | Professional | 56 · Pre-op care only | $23.44 | $23.99 | $25.70 |
Where Virginia sits
The same service costs 10.7 times more in Colorado 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· 18th of 51
$1,230
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.