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 $134.90 Median $3,981.07 Typical High $14,125.38 | Facility | None | $134.90 | $3,981.07 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $134.90 Typical High $186.21 | Professional | None | $123.03 | $134.90 | $186.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $85.11 Median $120.23 Typical High $141.25 | Professional | None | $85.11 | $120.23 | $141.25 |
CareFirst Setting Professional Modifier None Typical Low $144.54 Median $158.49 Typical High $190.55 | Professional | None | $144.54 | $158.49 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,174.90 Typical High $7,079.46 | Facility | None | $512.86 | $1,174.90 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $117.49 Typical High $186.21 | Professional | None | $112.20 | $117.49 | $186.21 |
Kaiser Permanente Setting Professional Modifier None Typical Low $114.82 Median $138.04 Typical High $169.82 | Professional | None | $114.82 | $138.04 | $169.82 |
Medcost Setting Facility Modifier None Typical Low $134.90 Median $165.96 Typical High $204.17 | Facility | None | $134.90 | $165.96 | $204.17 |
Medcost Setting Professional Modifier None Typical Low $151.36 Median $190.55 Typical High $190.55 | Professional | None | $151.36 | $190.55 | $190.55 |
Sentara Setting Facility Modifier None Typical Low $93.33 Median $371.54 Typical High $10,232.93 | Facility | None | $93.33 | $371.54 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $85.11 Median $144.54 Typical High $288.40 | Professional | None | $85.11 | $144.54 | $288.40 |
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 $79.43 Median $109.65 Typical High $213.80 | Professional | None | $79.43 | $109.65 | $213.80 |
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 $61.66 Median $67.61 Typical High $67.61 | Professional | 52 · Reduced service | $61.66 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $26.92 Typical High $26.92 | Professional | 53 · Discontinued | $24.55 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $102.33 Typical High $102.33 | Professional | 54 · Surgery only | $91.20 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $20.42 Typical High $20.42 | Professional | 55 · Aftercare only | $18.20 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $13.49 Typical High $13.49 | Professional | 56 · Pre-op care only | $12.30 | $13.49 | $13.49 |
Where Virginia sits
The same service costs 4.0 times more in Alaska than in Delaware. 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· 41st 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.