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 $1,202.26 Median $7,585.78 Typical High $16,218.10 | Facility | None | $1,202.26 | $7,585.78 | $16,218.10 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,202.26 Typical High $7,079.46 | Professional | None | $1,071.52 | $1,202.26 | $7,079.46 |
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 $954.99 Median $1,122.02 Typical High $1,380.38 | Professional | None | $954.99 | $1,122.02 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,174.90 Typical High $5,495.41 | Facility | None | $512.86 | $1,174.90 | $5,495.41 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $1,621.81 | Professional | None | $1,096.48 | $1,318.26 | $1,621.81 |
Medcost Setting Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,819.70 | Facility | None | $1,202.26 | $1,202.26 | $1,819.70 |
Medcost Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,047.13 | $1,047.13 | $1,047.13 |
Sentara Setting Facility Modifier None Typical Low $933.25 Median $1,737.80 Typical High $5,495.41 | Facility | None | $933.25 | $1,737.80 | $5,495.41 |
Sentara Setting Professional Modifier None Typical Low $1,096.48 Median $1,445.44 Typical High $5,370.32 | Professional | None | $1,096.48 | $1,445.44 | $5,370.32 |
United Setting Facility Modifier None Typical Low $4,570.88 Median $13,489.63 Typical High $36,307.81 | Facility | None | $4,570.88 | $13,489.63 | $36,307.81 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,621.81 Typical High $2,454.71 | Professional | None | $1,000.00 | $1,621.81 | $2,454.71 |
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 $537.03 Median $588.84 Typical High $602.56 | Professional | 52 · Reduced service | $537.03 | $588.84 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $234.42 Typical High $239.88 | Professional | 53 · Discontinued | $213.80 | $234.42 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $173.78 Typical High $181.97 | Professional | 55 · Aftercare only | $158.49 | $173.78 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $117.49 Typical High $120.23 | Professional | 56 · Pre-op care only | $107.15 | $117.49 | $120.23 |
Where Virginia sits
The same service costs 18.2 times more in California 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
$1,259
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.