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 $416.87 Median $5,128.61 Typical High $10,000.00 | Facility | None | $416.87 | $5,128.61 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $416.87 | Professional | None | $407.38 | $407.38 | $416.87 |
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 $190.55 Median $223.87 Typical High $245.47 | Professional | None | $190.55 | $223.87 | $245.47 |
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 $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,778.28 | $1,778.28 | $1,778.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $323.59 Median $380.19 Typical High $478.63 | Professional | None | $323.59 | $380.19 | $478.63 |
Medcost Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $645.65 | Facility | None | $416.87 | $416.87 | $645.65 |
Medcost Setting Professional Modifier None Typical Low $251.19 Median $363.08 Typical High $371.54 | Professional | None | $251.19 | $363.08 | $371.54 |
Sentara Setting Facility Modifier None Typical Low $371.54 Median $977.24 Typical High $3,715.35 | Facility | None | $371.54 | $977.24 | $3,715.35 |
Sentara Setting Professional Modifier None Typical Low $380.19 Median $436.52 Typical High $724.44 | Professional | None | $380.19 | $436.52 | $724.44 |
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 $316.23 Median $380.19 Typical High $676.08 | Professional | None | $316.23 | $380.19 | $676.08 |
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 $194.98 Median $204.17 Typical High $208.93 | Professional | 52 · Reduced service | $194.98 | $204.17 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $81.28 Typical High $83.18 | Professional | 53 · Discontinued | $77.62 | $81.28 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $60.26 Typical High $63.10 | Professional | 55 · Aftercare only | $58.88 | $60.26 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $40.74 Typical High $41.69 | Professional | 56 · Pre-op care only | $38.90 | $40.74 | $41.69 |
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· 50th of 51
$240
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.