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 $21.38 Median $4,365.16 Typical High $14,125.38 | Facility | None | $21.38 | $4,365.16 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
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 $128.82 Median $151.36 Typical High $165.96 | Professional | None | $128.82 | $151.36 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $186.21 Typical High $407.38 | Facility | None | $181.97 | $186.21 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
Kaiser Permanente Setting Professional Modifier None Typical Low $19.50 Median $22.91 Typical High $28.84 | Professional | None | $19.50 | $22.91 | $28.84 |
Medcost Setting Facility Modifier None Typical Low $21.38 Median $21.38 Typical High $33.11 | Facility | None | $21.38 | $21.38 | $33.11 |
Sentara Setting Facility Modifier None Typical Low $19.05 Median $302.00 Typical High $2,454.71 | Facility | None | $19.05 | $302.00 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $19.50 Median $22.91 Typical High $32.36 | Professional | None | $19.50 | $22.91 | $32.36 |
United Setting Facility Modifier None Typical Low $100.00 Median $660.69 Typical High $2,089.30 | Facility | None | $100.00 | $660.69 | $2,089.30 |
United Setting Professional Modifier None Typical Low $17.38 Median $20.89 Typical High $37.15 | Professional | None | $17.38 | $20.89 | $37.15 |
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 $10.72 Median $10.72 Typical High $10.72 | Professional | 52 · Reduced service | $10.72 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.27 Median $4.27 Typical High $4.37 | Professional | 53 · Discontinued | $4.27 | $4.27 | $4.37 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $15.85 Median $15.85 Typical High $16.22 | Professional | 54 · Surgery only | $15.85 | $15.85 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | 55 · Aftercare only | $3.24 | $3.24 | $3.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.14 Median $2.14 Typical High $2.14 | Professional | 56 · Pre-op care only | $2.14 | $2.14 | $2.14 |
Where Virginia sits
The same service costs 14.5 times more in New Hampshire than in New Jersey. 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· 10th of 51
$135
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.