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 $457.09 Median $5,888.44 Typical High $14,125.38 | Facility | None | $457.09 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $457.09 Typical High $5,370.32 | Professional | None | $354.81 | $457.09 | $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 $302.00 Median $346.74 Typical High $446.68 | Professional | None | $302.00 | $346.74 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $7,413.10 Typical High $14,791.08 | Facility | None | $512.86 | $7,413.10 | $14,791.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $338.84 Median $407.38 Typical High $501.19 | Professional | None | $338.84 | $407.38 | $501.19 |
Medcost Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $691.83 | Facility | None | $457.09 | $457.09 | $691.83 |
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 $407.38 Median $1,096.48 Typical High $18,620.87 | Facility | None | $407.38 | $1,096.48 | $18,620.87 |
Sentara Setting Professional Modifier None Typical Low $389.05 Median $537.03 Typical High $12,589.25 | Professional | None | $389.05 | $537.03 | $12,589.25 |
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 $371.54 Median $602.56 Typical High $933.25 | Professional | None | $371.54 | $602.56 | $933.25 |
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 $199.53 Typical High $229.09 | Professional | 52 · Reduced service | $177.83 | $199.53 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $79.43 Typical High $91.20 | Professional | 53 · Discontinued | $70.79 | $79.43 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $302.00 Typical High $338.84 | Professional | 54 · Surgery only | $269.15 | $302.00 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $60.26 Typical High $67.61 | Professional | 55 · Aftercare only | $53.70 | $60.26 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $39.81 Typical High $45.71 | Professional | 56 · Pre-op care only | $35.48 | $39.81 | $45.71 |
Where Virginia sits
The same service costs 32.4 times more in Oklahoma than in New York. 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
$457
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.