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 $1,023.29 Median $4,786.30 Typical High $14,125.38 | Facility | None | $1,023.29 | $4,786.30 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,772.37 Median $12,022.64 Typical High $15,848.93 | Facility | None | $9,772.37 | $12,022.64 | $15,848.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $1,479.11 Typical High $1,819.70 | Professional | None | $1,258.93 | $1,479.11 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,905.46 Median $2,238.72 Typical High $2,754.23 | Professional | 50 · Both sides | $1,905.46 | $2,238.72 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $794.33 Typical High $3,019.95 | Facility | None | $512.86 | $794.33 | $3,019.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $933.25 Median $1,122.02 Typical High $1,380.38 | Professional | None | $933.25 | $1,122.02 | $1,380.38 |
Medcost Setting Facility Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,584.89 | Facility | None | $1,023.29 | $1,023.29 | $1,584.89 |
Sentara Setting Facility Modifier None Typical Low $398.11 Median $1,071.52 Typical High $4,265.80 | Facility | None | $398.11 | $1,071.52 | $4,265.80 |
Sentara Setting Professional Modifier None Typical Low $933.25 Median $1,202.26 Typical High $2,089.30 | Professional | None | $933.25 | $1,202.26 | $2,089.30 |
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 $707.95 Median $1,000.00 Typical High $1,862.09 | Professional | None | $707.95 | $1,000.00 | $1,862.09 |
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 $512.86 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $512.86 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $204.17 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $776.25 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $102.33 |
Where Virginia sits
The same service costs 50.1 times more in Oklahoma than in North Carolina. 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· 32nd 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.