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 $199.53 Median $7,079.46 Typical High $15,488.17 | Facility | None | $199.53 | $7,079.46 | $15,488.17 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $2,818.38 Typical High $3,311.31 | Professional | None | $186.21 | $2,818.38 | $3,311.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $7,413.10 Typical High $9,549.93 | Facility | None | $6,165.95 | $7,413.10 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $158.49 Median $190.55 Typical High $239.88 | Professional | None | $158.49 | $190.55 | $239.88 |
CareFirst Setting Professional Modifier None Typical Low $158.49 Median $173.78 Typical High $4,365.16 | Professional | None | $158.49 | $173.78 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $4,265.80 Typical High $7,943.28 | Facility | None | $524.81 | $4,265.80 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $489.78 Typical High $4,265.80 | Professional | None | $169.82 | $489.78 | $4,265.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $141.25 Median $2,818.38 Typical High $3,548.13 | Professional | None | $141.25 | $2,818.38 | $3,548.13 |
Medcost Setting Facility Modifier None Typical Low $186.21 Median $281.84 Typical High $4,897.79 | Facility | None | $186.21 | $281.84 | $4,897.79 |
Medcost Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Professional | None | $3,388.44 | $3,388.44 | $3,388.44 |
Sentara Setting Facility Modifier None Typical Low $169.82 Median $2,454.71 Typical High $11,481.54 | Facility | None | $169.82 | $2,454.71 | $11,481.54 |
Sentara Setting Professional Modifier None Typical Low $2,884.03 Median $3,715.35 Typical High $9,549.93 | Professional | None | $2,884.03 | $3,715.35 | $9,549.93 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $8,511.38 Typical High $20,417.38 | Facility | None | $1,995.26 | $8,511.38 | $20,417.38 |
United Setting Professional Modifier None Typical Low $151.36 Median $501.19 Typical High $5,623.41 | Professional | None | $151.36 | $501.19 | $5,623.41 |
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 $93.33 Median $190.55 Typical High $1,659.59 | Professional | 52 · Reduced service | $93.33 | $190.55 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $75.86 Typical High $660.69 | Professional | 53 · Discontinued | $37.15 | $75.86 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $281.84 Typical High $2,454.71 | Professional | 54 · Surgery only | $138.04 | $281.84 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $56.23 Typical High $489.78 | Professional | 55 · Aftercare only | $27.54 | $56.23 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $38.02 Typical High $331.13 | Professional | 56 · Pre-op care only | $18.62 | $38.02 | $331.13 |
Where Virginia sits
The same service costs 33.1 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· 50th of 51
$251
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.