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 $87.10 Median $4,365.16 Typical High $14,125.38 | Facility | None | $87.10 | $4,365.16 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $125.89 Typical High $204.17 | Professional | None | $74.13 | $125.89 | $204.17 |
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 $69.18 Median $125.89 Typical High $190.55 | Professional | None | $69.18 | $125.89 | $190.55 |
CareFirst Setting Professional Modifier None Typical Low $72.44 Median $81.28 Typical High $95.50 | Professional | None | $72.44 | $81.28 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $109.65 Typical High $204.17 | Facility | None | $50.12 | $109.65 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $131.83 Typical High $194.98 | Professional | None | $69.18 | $131.83 | $194.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $138.04 Median $181.97 Typical High $213.80 | Professional | None | $138.04 | $181.97 | $213.80 |
Medcost Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $162.18 | Professional | None | $141.25 | $141.25 | $162.18 |
Medcost Setting Facility Modifier None Typical Low $87.10 Median $141.25 Typical High $288.40 | Facility | None | $87.10 | $141.25 | $288.40 |
Medcost Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
Sentara Setting Facility Modifier None Typical Low $66.07 Median $371.54 Typical High $2,454.71 | Facility | None | $66.07 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $97.72 Median $177.83 Typical High $1,071.52 | Professional | None | $97.72 | $177.83 | $1,071.52 |
United Setting Facility Modifier None Typical Low $100.00 Median $660.69 Typical High $2,041.74 | Facility | None | $100.00 | $660.69 | $2,041.74 |
United Setting Professional Modifier None Typical Low $63.10 Median $120.23 Typical High $234.42 | Professional | None | $63.10 | $120.23 | $234.42 |
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 $37.15 Median $57.54 Typical High $89.13 | Professional | 52 · Reduced service | $37.15 | $57.54 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $22.91 Typical High $35.48 | Professional | 53 · Discontinued | $14.79 | $22.91 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $85.11 Typical High $131.83 | Professional | 54 · Surgery only | $56.23 | $85.11 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $16.98 Typical High $26.30 | Professional | 55 · Aftercare only | $11.22 | $16.98 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $11.48 Typical High $17.78 | Professional | 56 · Pre-op care only | $7.41 | $11.48 | $17.78 |
Where Virginia sits
The same service costs 3.2 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· 28th 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.