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 $2,238.72 Median $10,000.00 Typical High $20,417.38 | Facility | None | $2,238.72 | $10,000.00 | $20,417.38 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $2,238.72 Typical High $7,079.46 | Professional | None | $1,819.70 | $2,238.72 | $7,079.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,232.93 Median $23,988.33 Typical High $44,668.36 | Facility | None | $10,232.93 | $23,988.33 | $44,668.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,380.38 Median $1,584.89 Typical High $2,041.74 | Professional | None | $1,380.38 | $1,584.89 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $794.33 Typical High $5,495.41 | Facility | None | $501.19 | $794.33 | $5,495.41 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,479.11 Median $1,778.28 Typical High $2,187.76 | Professional | None | $1,479.11 | $1,778.28 | $2,187.76 |
Medcost Setting Facility Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $3,388.44 | Facility | None | $2,238.72 | $2,238.72 | $3,388.44 |
Medcost Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,949.84 | $1,949.84 | $1,949.84 |
Sentara Setting Facility Modifier None Typical Low $1,348.96 Median $2,344.23 Typical High $8,912.51 | Facility | None | $1,348.96 | $2,344.23 | $8,912.51 |
Sentara Setting Professional Modifier None Typical Low $1,737.80 Median $2,454.71 Typical High $7,413.10 | Professional | None | $1,737.80 | $2,454.71 | $7,413.10 |
United Setting Facility Modifier None Typical Low $436.52 Median $2,344.23 Typical High $6,309.57 | Facility | None | $436.52 | $2,344.23 | $6,309.57 |
United Setting Professional Modifier None Typical Low $1,778.28 Median $2,884.03 Typical High $4,466.84 | Professional | None | $1,778.28 | $2,884.03 | $4,466.84 |
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 $870.96 Median $977.24 Typical High $1,122.02 | Professional | 52 · Reduced service | $870.96 | $977.24 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $389.05 Typical High $446.68 | Professional | 53 · Discontinued | $354.81 | $389.05 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,513.56 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,318.26 | $1,513.56 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $295.12 Typical High $338.84 | Professional | 55 · Aftercare only | $263.03 | $295.12 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $194.98 Typical High $223.87 | Professional | 56 · Pre-op care only | $173.78 | $194.98 | $223.87 |
Where Virginia sits
The same service costs 5.8 times more in California than in Arkansas. 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· 33rd of 51
$2,188
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.