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 $177.83 Median $4,073.80 Typical High $10,000.00 | Facility | None | $177.83 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $251.19 Typical High $275.42 | Professional | None | $165.96 | $251.19 | $275.42 |
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 $147.91 Median $177.83 Typical High $213.80 | Professional | None | $147.91 | $177.83 | $213.80 |
CareFirst Setting Professional Modifier None Typical Low $128.82 Median $141.25 Typical High $169.82 | Professional | None | $128.82 | $141.25 | $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 $154.88 Median $234.42 Typical High $346.74 | Professional | None | $154.88 | $234.42 | $346.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $275.42 Median $331.13 Typical High $426.58 | Professional | None | $275.42 | $331.13 | $426.58 |
Medcost Setting Professional Modifier None Typical Low $281.84 Median $346.74 Typical High $346.74 | Professional | None | $281.84 | $346.74 | $346.74 |
Medcost Setting Facility Modifier None Typical Low $177.83 Median $275.42 Typical High $446.68 | Facility | None | $177.83 | $275.42 | $446.68 |
Medcost Setting Professional Modifier None Typical Low $199.53 Median $245.47 Typical High $275.42 | Professional | None | $199.53 | $245.47 | $275.42 |
Sentara Setting Facility Modifier None Typical Low $138.04 Median $380.19 Typical High $2,454.71 | Facility | None | $138.04 | $380.19 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $173.78 Median $295.12 Typical High $588.84 | Professional | None | $173.78 | $295.12 | $588.84 |
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 $120.23 Median $199.53 Typical High $380.19 | Professional | None | $120.23 | $199.53 | $380.19 |
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 $83.18 Median $120.23 Typical High $138.04 | Professional | 52 · Reduced service | $83.18 | $120.23 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $47.86 Typical High $54.95 | Professional | 53 · Discontinued | $33.11 | $47.86 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $181.97 Typical High $204.17 | Professional | 54 · Surgery only | $123.03 | $181.97 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $36.31 Typical High $40.74 | Professional | 55 · Aftercare only | $24.55 | $36.31 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $23.99 Typical High $27.54 | Professional | 56 · Pre-op care only | $16.60 | $23.99 | $27.54 |
Where Virginia sits
The same service costs 3.9 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· 48th of 51
$186
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.