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 $630.96 Median $5,370.32 Typical High $14,125.38 | Facility | None | $630.96 | $5,370.32 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $630.96 Typical High $4,365.16 | Professional | None | $562.34 | $630.96 | $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 $75.86 Median $89.13 Typical High $112.20 | Professional | None | $75.86 | $89.13 | $112.20 |
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 $302.00 Median $363.08 Typical High $446.68 | Professional | None | $302.00 | $363.08 | $446.68 |
Medcost Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $954.99 | Facility | None | $630.96 | $630.96 | $954.99 |
Medcost Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | None | $537.03 | $537.03 | $537.03 |
Sentara Setting Facility Modifier None Typical Low $512.86 Median $1,513.56 Typical High $10,232.93 | Facility | None | $512.86 | $1,513.56 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $446.68 Median $758.58 Typical High $10,232.93 | Professional | None | $446.68 | $758.58 | $10,232.93 |
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 $512.86 Median $851.14 Typical High $1,258.93 | Professional | None | $512.86 | $851.14 | $1,258.93 |
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 $275.42 Median $302.00 Typical High $316.23 | Professional | 52 · Reduced service | $275.42 | $302.00 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $120.23 Typical High $125.89 | Professional | 53 · Discontinued | $109.65 | $120.23 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $457.09 Typical High $478.63 | Professional | 54 · Surgery only | $416.87 | $457.09 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $91.20 Typical High $95.50 | Professional | 55 · Aftercare only | $83.18 | $91.20 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $60.26 Typical High $63.10 | Professional | 56 · Pre-op care only | $54.95 | $60.26 | $63.10 |
Where Virginia sits
The same service costs 10.2 times more in Texas 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· 47th of 51
$575
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.