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 $181.97 Median $4,365.16 Typical High $14,125.38 | Facility | None | $181.97 | $4,365.16 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $251.19 Typical High $302.00 | Professional | None | $165.96 | $251.19 | $302.00 |
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 $151.36 Median $181.97 Typical High $218.78 | Professional | None | $151.36 | $181.97 | $218.78 |
CareFirst Setting Professional Modifier None Typical Low $128.82 Median $144.54 Typical High $169.82 | Professional | None | $128.82 | $144.54 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $162.18 Typical High $302.00 | Facility | None | $50.12 | $162.18 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $239.88 Typical High $371.54 | Professional | None | $158.49 | $239.88 | $371.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $309.03 Median $371.54 Typical High $478.63 | Professional | None | $309.03 | $371.54 | $478.63 |
Medcost Setting Professional Modifier None Typical Low $288.40 Median $354.81 Typical High $354.81 | Professional | None | $288.40 | $354.81 | $354.81 |
Medcost Setting Facility Modifier None Typical Low $181.97 Median $295.12 Typical High $489.78 | Facility | None | $181.97 | $295.12 | $489.78 |
Medcost Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $263.03 | Professional | None | $257.04 | $257.04 | $263.03 |
Sentara Setting Facility Modifier None Typical Low $138.04 Median $371.54 Typical High $2,454.71 | Facility | None | $138.04 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $190.55 Median $295.12 Typical High $645.65 | Professional | None | $190.55 | $295.12 | $645.65 |
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 $123.03 Median $213.80 Typical High $389.05 | Professional | None | $123.03 | $213.80 | $389.05 |
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 $83.18 Median $123.03 Typical High $151.36 | Professional | 52 · Reduced service | $83.18 | $123.03 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $48.98 Typical High $60.26 | Professional | 53 · Discontinued | $33.11 | $48.98 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $181.97 Typical High $229.09 | Professional | 54 · Surgery only | $125.89 | $181.97 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $36.31 Typical High $45.71 | Professional | 55 · Aftercare only | $25.12 | $36.31 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $24.55 Typical High $30.20 | Professional | 56 · Pre-op care only | $16.60 | $24.55 | $30.20 |
Where Virginia sits
The same service costs 3.6 times more in Alaska than in Maryland. 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· 50th of 51
$191
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.