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 $151.36 Median $4,365.16 Typical High $14,125.38 | Facility | None | $151.36 | $4,365.16 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $151.36 Typical High $2,570.40 | Professional | None | $128.82 | $151.36 | $2,570.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $2,398.83 Typical High $2,951.21 | Facility | None | $1,698.24 | $2,398.83 | $2,951.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $114.82 Median $134.90 Typical High $169.82 | Professional | None | $114.82 | $134.90 | $169.82 |
CareFirst Setting Professional Modifier None Typical Low $97.72 Median $109.65 Typical High $144.54 | Professional | None | $97.72 | $109.65 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $524.81 Typical High $2,187.76 | Facility | None | $316.23 | $524.81 | $2,187.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $109.65 Median $2,398.83 Typical High $2,951.21 | Professional | None | $109.65 | $2,398.83 | $2,951.21 |
Medcost Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $229.09 | Facility | None | $151.36 | $151.36 | $229.09 |
Medcost Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
Sentara Setting Facility Modifier None Typical Low $134.90 Median $616.60 Typical High $2,951.21 | Facility | None | $134.90 | $616.60 | $2,951.21 |
Sentara Setting Professional Modifier None Typical Low $138.04 Median $199.53 Typical High $2,454.71 | Professional | None | $138.04 | $199.53 | $2,454.71 |
United Setting Facility Modifier None Typical Low $323.59 Median $1,445.44 Typical High $3,630.78 | Facility | None | $323.59 | $1,445.44 | $3,630.78 |
United Setting Professional Modifier None Typical Low $114.82 Median $199.53 Typical High $302.00 | Professional | None | $114.82 | $199.53 | $302.00 |
4 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 $64.57 Median $75.86 Typical High $75.86 | Professional | 52 · Reduced service | $64.57 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $30.20 Typical High $30.20 | Professional | 53 · Discontinued | $25.70 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $22.39 Typical High $22.39 | Professional | 55 · Aftercare only | $19.05 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $15.14 Typical High $15.14 | Professional | 56 · Pre-op care only | $12.88 | $15.14 | $15.14 |
Where Virginia sits
The same service costs 24.5 times more in Texas than in Missouri. 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· 46th of 51
$151
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.