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 $275.42 Median $4,365.16 Typical High $14,125.38 | Facility | None | $275.42 | $4,365.16 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $275.42 Typical High $2,570.40 | Professional | None | $190.55 | $275.42 | $2,570.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $66.07 Median $77.62 Typical High $100.00 | Professional | None | $66.07 | $77.62 | $100.00 |
CareFirst Setting Professional Modifier None Typical Low $87.10 Median $97.72 Typical High $691.83 | Professional | None | $87.10 | $97.72 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,230.27 Typical High $3,019.95 | Facility | None | $512.86 | $1,230.27 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $190.55 Typical High $501.19 | Professional | None | $177.83 | $190.55 | $501.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $186.21 Median $223.87 Typical High $275.42 | Professional | None | $186.21 | $223.87 | $275.42 |
Medcost Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $416.87 | Facility | None | $275.42 | $275.42 | $416.87 |
Medcost Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
Sentara Setting Facility Modifier None Typical Low $302.00 Median $691.83 Typical High $7,413.10 | Facility | None | $302.00 | $691.83 | $7,413.10 |
Sentara Setting Professional Modifier None Typical Low $190.55 Median $363.08 Typical High $1,479.11 | Professional | None | $190.55 | $363.08 | $1,479.11 |
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 $151.36 Median $281.84 Typical High $436.52 | Professional | None | $151.36 | $281.84 | $436.52 |
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 $93.33 Median $131.83 Typical High $134.90 | Professional | 52 · Reduced service | $93.33 | $131.83 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $52.48 Typical High $54.95 | Professional | 53 · Discontinued | $37.15 | $52.48 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $204.17 Typical High $204.17 | Professional | 54 · Surgery only | $141.25 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $38.90 Typical High $40.74 | Professional | 55 · Aftercare only | $28.18 | $38.90 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $26.30 Typical High $27.54 | Professional | 56 · Pre-op care only | $18.62 | $26.30 | $27.54 |
Where Virginia sits
The same service costs 7.2 times more in Oklahoma than in Virginia. 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· 51st of 51
$138
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.