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 $107.15 Median $1,819.70 Typical High $8,317.64 | Facility | None | $107.15 | $1,819.70 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $154.88 Typical High $245.47 | Professional | None | $91.20 | $154.88 | $245.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $3,715.35 Typical High $4,265.80 | Facility | None | $2,884.03 | $3,715.35 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $87.10 Median $131.83 Typical High $194.98 | Professional | None | $87.10 | $131.83 | $194.98 |
CareFirst Setting Professional Modifier None Typical Low $85.11 Median $95.50 Typical High $112.20 | Professional | None | $85.11 | $95.50 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $213.80 Typical High $1,659.59 | Facility | None | $95.50 | $213.80 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $151.36 Typical High $229.09 | Professional | None | $87.10 | $151.36 | $229.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $144.54 Median $190.55 Typical High $223.87 | Professional | None | $144.54 | $190.55 | $223.87 |
Medcost Setting Facility Modifier None Typical Low $107.15 Median $169.82 Typical High $281.84 | Facility | None | $107.15 | $169.82 | $281.84 |
Medcost Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
Sentara Setting Facility Modifier None Typical Low $97.72 Median $891.25 Typical High $3,630.78 | Facility | None | $97.72 | $891.25 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $158.49 Median $194.98 Typical High $2,570.40 | Professional | None | $158.49 | $194.98 | $2,570.40 |
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 $89.13 Median $147.91 Typical High $251.19 | Professional | None | $89.13 | $147.91 | $251.19 |
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 $45.71 Median $58.88 Typical High $85.11 | Professional | 52 · Reduced service | $45.71 | $58.88 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $22.39 Typical High $33.88 | Professional | 53 · Discontinued | $18.20 | $22.39 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $89.13 Typical High $128.82 | Professional | 54 · Surgery only | $67.61 | $89.13 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $17.78 Typical High $25.70 | Professional | 55 · Aftercare only | $13.80 | $17.78 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $12.59 Typical High $16.98 | Professional | 56 · Pre-op care only | $9.12 | $12.59 | $16.98 |
Where Virginia sits
The same service costs 3.2 times more in Alaska 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· 39th of 51
$151
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.