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 $323.59 Median $4,786.30 Typical High $10,000.00 | Facility | None | $323.59 | $4,786.30 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $323.59 | Professional | None | $316.23 | $316.23 | $323.59 |
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 $162.18 Median $190.55 Typical High $208.93 | Professional | None | $162.18 | $190.55 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,047.13 Typical High $3,019.95 | Facility | None | $524.81 | $1,047.13 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $316.23 Median $363.08 Typical High $467.74 | Professional | None | $316.23 | $363.08 | $467.74 |
Medcost Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $501.19 | Facility | None | $323.59 | $323.59 | $501.19 |
Medcost Setting Professional Modifier None Typical Low $194.98 Median $281.84 Typical High $288.40 | Professional | None | $194.98 | $281.84 | $288.40 |
Sentara Setting Facility Modifier None Typical Low $288.40 Median $933.25 Typical High $3,715.35 | Facility | None | $288.40 | $933.25 | $3,715.35 |
Sentara Setting Professional Modifier None Typical Low $295.12 Median $338.84 Typical High $562.34 | Professional | None | $295.12 | $338.84 | $562.34 |
United Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $5,888.44 | Facility | None | $588.84 | $2,187.76 | $5,888.44 |
United Setting Professional Modifier None Typical Low $245.47 Median $295.12 Typical High $524.81 | Professional | None | $245.47 | $295.12 | $524.81 |
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 $151.36 Median $158.49 Typical High $162.18 | Professional | 52 · Reduced service | $151.36 | $158.49 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $63.10 Typical High $66.07 | Professional | 53 · Discontinued | $61.66 | $63.10 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $47.86 Typical High $48.98 | Professional | 55 · Aftercare only | $45.71 | $47.86 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $31.62 Typical High $32.36 | Professional | 56 · Pre-op care only | $30.90 | $31.62 | $32.36 |
Where Virginia sits
The same service costs 7.1 times more in Alaska 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· 49th of 51
$204
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.