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 $3,801.89 Median $10,000.00 Typical High $19,054.61 | Facility | None | $3,801.89 | $10,000.00 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,584.89 Typical High $9,549.93 | Professional | None | $1,412.54 | $1,584.89 | $9,549.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,912.51 Median $11,220.18 Typical High $17,378.01 | Facility | None | $8,912.51 | $11,220.18 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $870.96 Median $1,000.00 Typical High $1,258.93 | Professional | None | $870.96 | $1,000.00 | $1,258.93 |
CareFirst Setting Professional Modifier None Typical Low $229.09 Median $251.19 Typical High $316.23 | Professional | None | $229.09 | $251.19 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $4,466.84 Typical High $8,709.64 | Facility | None | $512.86 | $4,466.84 | $8,709.64 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,737.80 Median $2,089.30 Typical High $2,570.40 | Professional | None | $1,737.80 | $2,089.30 | $2,570.40 |
Medcost Setting Facility Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $2,187.76 | Facility | None | $1,445.44 | $1,445.44 | $2,187.76 |
Medcost Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
Sentara Setting Facility Modifier None Typical Low $1,148.15 Median $2,570.40 Typical High $11,481.54 | Facility | None | $1,148.15 | $2,570.40 | $11,481.54 |
Sentara Setting Professional Modifier None Typical Low $1,288.25 Median $1,862.09 Typical High $10,232.93 | Professional | None | $1,288.25 | $1,862.09 | $10,232.93 |
United Setting Facility Modifier None Typical Low $2,570.40 Median $10,000.00 Typical High $25,118.86 | Facility | None | $2,570.40 | $10,000.00 | $25,118.86 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,905.46 Typical High $2,951.21 | Professional | None | $1,202.26 | $1,905.46 | $2,951.21 |
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 $707.95 Median $707.95 Typical High $794.33 | Professional | 52 · Reduced service | $707.95 | $707.95 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $288.40 Typical High $323.59 | Professional | 53 · Discontinued | $281.84 | $288.40 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $239.88 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $144.54 Typical High $158.49 | Professional | 56 · Pre-op care only | $141.25 | $144.54 | $158.49 |
Where Virginia sits
The same service costs 9.1 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· 48th of 51
$1,445
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.