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 $870.96 Median $5,888.44 Typical High $14,125.38 | Facility | None | $870.96 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $776.25 Typical High $5,370.32 | Professional | None | $354.81 | $776.25 | $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 $36.31 Median $36.31 Typical High $676.08 | Professional | None | $36.31 | $36.31 | $676.08 |
CareFirst Setting Professional Modifier None Typical Low $2,884.03 Median $3,548.13 Typical High $6,760.83 | Professional | None | $2,884.03 | $3,548.13 | $6,760.83 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $4,897.79 Typical High $9,772.37 | Facility | None | $512.86 | $4,897.79 | $9,772.37 |
Kaiser Permanente Setting Professional Modifier None Typical Low $691.83 Median $831.76 Typical High $1,023.29 | Professional | None | $691.83 | $831.76 | $1,023.29 |
Medcost Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $537.03 | Facility | None | $354.81 | $354.81 | $537.03 |
Medcost Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
Sentara Setting Facility Modifier None Typical Low $512.86 Median $2,238.72 Typical High $10,232.93 | Facility | None | $512.86 | $2,238.72 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $446.68 Median $933.25 Typical High $10,964.78 | Professional | None | $446.68 | $933.25 | $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 $309.03 Median $512.86 Typical High $776.25 | Professional | None | $309.03 | $512.86 | $776.25 |
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 $177.83 Median $194.98 Typical High $436.52 | Professional | 52 · Reduced service | $177.83 | $194.98 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $79.43 Typical High $173.78 | Professional | 53 · Discontinued | $70.79 | $79.43 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $295.12 Typical High $660.69 | Professional | 54 · Surgery only | $263.03 | $295.12 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $58.88 Typical High $131.83 | Professional | 55 · Aftercare only | $52.48 | $58.88 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $38.90 Typical High $87.10 | Professional | 56 · Pre-op care only | $35.48 | $38.90 | $87.10 |
Where Virginia sits
The same service costs 14.8 times more in Texas 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· 16th of 51
$1,549
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.