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 $1,949.84 Median $5,370.32 Typical High $14,125.38 | Facility | None | $1,949.84 | $5,370.32 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,949.84 Typical High $4,365.16 | Professional | None | $1,230.27 | $1,949.84 | $4,365.16 |
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 $776.25 Median $891.25 Typical High $1,148.15 | Professional | None | $776.25 | $891.25 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $2,238.72 Typical High $4,073.80 | Facility | None | $512.86 | $2,238.72 | $4,073.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,548.82 Median $1,862.09 Typical High $2,290.87 | Professional | None | $1,548.82 | $1,862.09 | $2,290.87 |
Medcost Setting Facility Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $3,019.95 | Facility | None | $1,949.84 | $1,949.84 | $3,019.95 |
Medcost Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,905.46 | $1,905.46 | $1,905.46 |
Sentara Setting Facility Modifier None Typical Low $1,412.54 Median $2,818.38 Typical High $10,232.93 | Facility | None | $1,412.54 | $2,818.38 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1,621.81 Median $3,630.78 Typical High $10,964.78 | Professional | None | $1,621.81 | $3,630.78 | $10,964.78 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $6,760.83 Typical High $16,595.87 | Facility | None | $1,548.82 | $6,760.83 | $16,595.87 |
United Setting Professional Modifier None Typical Low $1,737.80 Median $2,818.38 Typical High $4,265.80 | Professional | None | $1,737.80 | $2,818.38 | $4,265.80 |
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 $616.60 Median $954.99 Typical High $977.24 | Professional | 52 · Reduced service | $616.60 | $954.99 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $380.19 Typical High $398.11 | Professional | 53 · Discontinued | $251.19 | $380.19 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,445.44 Typical High $1,479.11 | Professional | 54 · Surgery only | $933.25 | $1,445.44 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $281.84 Typical High $295.12 | Professional | 55 · Aftercare only | $186.21 | $281.84 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $190.55 Typical High $194.98 | Professional | 56 · Pre-op care only | $123.03 | $190.55 | $194.98 |
Where Virginia sits
The same service costs 15.8 times more in Wisconsin than in Nebraska. 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· 49th of 51
$1,479
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.