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 $229.09 Median $4,365.16 Typical High $10,000.00 | Facility | None | $229.09 | $4,365.16 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $229.09 Typical High $281.84 | Professional | None | $144.54 | $229.09 | $281.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $6,456.54 Typical High $7,244.36 | Facility | None | $4,677.35 | $6,456.54 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $128.82 Median $199.53 Typical High $288.40 | Professional | None | $128.82 | $199.53 | $288.40 |
CareFirst Setting Professional Modifier None Typical Low $125.89 Median $141.25 Typical High $3,548.13 | Professional | None | $125.89 | $141.25 | $3,548.13 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,698.24 Typical High $3,235.94 | Facility | None | $478.63 | $1,698.24 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $208.93 Typical High $331.13 | Professional | None | $131.83 | $208.93 | $331.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $109.65 Median $251.19 Typical High $316.23 | Professional | None | $109.65 | $251.19 | $316.23 |
Medcost Setting Professional Modifier None Typical Low $263.03 Median $323.59 Typical High $323.59 | Professional | None | $263.03 | $323.59 | $323.59 |
Medcost Setting Facility Modifier None Typical Low $144.54 Median $229.09 Typical High $380.19 | Facility | None | $144.54 | $229.09 | $380.19 |
Medcost Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
Sentara Setting Facility Modifier None Typical Low $131.83 Median $933.25 Typical High $8,709.64 | Facility | None | $131.83 | $933.25 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $194.98 Median $269.15 Typical High $4,073.80 | Professional | None | $194.98 | $269.15 | $4,073.80 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,011.87 Typical High $13,182.57 | Facility | None | $1,230.27 | $5,011.87 | $13,182.57 |
United Setting Professional Modifier None Typical Low $112.20 Median $204.17 Typical High $363.08 | Professional | None | $112.20 | $204.17 | $363.08 |
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 $72.44 Median $87.10 Typical High $134.90 | Professional | 52 · Reduced service | $72.44 | $87.10 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $34.67 Typical High $53.70 | Professional | 53 · Discontinued | $28.84 | $34.67 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $128.82 Typical High $199.53 | Professional | 54 · Surgery only | $109.65 | $128.82 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $26.30 Typical High $39.81 | Professional | 55 · Aftercare only | $21.88 | $26.30 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $17.38 Typical High $26.92 | Professional | 56 · Pre-op care only | $14.45 | $17.38 | $26.92 |
Where Virginia sits
The same service costs 3.7 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· 40th of 51
$219
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.