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 $288.40 Median $4,365.16 Typical High $14,125.38 | Facility | None | $288.40 | $4,365.16 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $288.40 Typical High $288.40 | Professional | None | $275.42 | $288.40 | $288.40 |
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 $138.04 Median $218.78 Typical High $275.42 | Professional | None | $138.04 | $218.78 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $12,302.69 Typical High $23,442.29 | Facility | None | $512.86 | $12,302.69 | $23,442.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $245.47 Median $288.40 Typical High $363.08 | Professional | None | $245.47 | $288.40 | $363.08 |
Medcost Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $436.52 | Facility | None | $288.40 | $288.40 | $436.52 |
Medcost Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
Sentara Setting Facility Modifier None Typical Low $257.04 Median $954.99 Typical High $11,481.54 | Facility | None | $257.04 | $954.99 | $11,481.54 |
Sentara Setting Professional Modifier None Typical Low $257.04 Median $338.84 Typical High $691.83 | Professional | None | $257.04 | $338.84 | $691.83 |
United Setting Facility Modifier None Typical Low $2,570.40 Median $10,000.00 Typical High $26,915.35 | Facility | None | $2,570.40 | $10,000.00 | $26,915.35 |
United Setting Professional Modifier None Typical Low $173.78 Median $257.04 Typical High $478.63 | Professional | None | $173.78 | $257.04 | $478.63 |
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 $128.82 Median $144.54 Typical High $144.54 | Professional | 52 · Reduced service | $128.82 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $57.54 Typical High $57.54 | Professional | 53 · Discontinued | $51.29 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $213.80 Typical High $213.80 | Professional | 54 · Surgery only | $194.98 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $42.66 Typical High $42.66 | Professional | 55 · Aftercare only | $38.90 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $28.84 Typical High $28.84 | Professional | 56 · Pre-op care only | $25.70 | $28.84 | $28.84 |
Where Virginia sits
The same service costs 9.5 times more in Arkansas than in Kentucky. 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· 29th of 51
$316
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.