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 $954.99 Median $5,495.41 Typical High $14,125.38 | Facility | None | $954.99 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $933.25 Typical High $1,778.28 | Professional | None | $870.96 | $933.25 | $1,778.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,964.78 Median $13,803.84 Typical High $15,848.93 | Facility | None | $10,964.78 | $13,803.84 | $15,848.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $851.14 Typical High $1,071.52 | Professional | None | $707.95 | $851.14 | $1,071.52 |
CareFirst Setting Professional Modifier None Typical Low $794.33 Median $891.25 Typical High $1,096.48 | Professional | None | $794.33 | $891.25 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $794.33 Typical High $5,495.41 | Facility | None | $501.19 | $794.33 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $1,000.00 Typical High $1,412.54 | Professional | None | $707.95 | $1,000.00 | $1,412.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $812.83 Typical High $1,000.00 | Professional | None | $676.08 | $812.83 | $1,000.00 |
Medcost Setting Facility Modifier None Typical Low $870.96 Median $1,047.13 Typical High $1,445.44 | Facility | None | $870.96 | $1,047.13 | $1,445.44 |
Medcost Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
Sentara Setting Facility Modifier None Typical Low $776.25 Median $1,548.82 Typical High $5,128.61 | Facility | None | $776.25 | $1,548.82 | $5,128.61 |
Sentara Setting Professional Modifier None Typical Low $794.33 Median $1,047.13 Typical High $3,981.07 | Professional | None | $794.33 | $1,047.13 | $3,981.07 |
United Setting Facility Modifier None Typical Low $436.52 Median $2,344.23 Typical High $6,309.57 | Facility | None | $436.52 | $2,344.23 | $6,309.57 |
United Setting Professional Modifier None Typical Low $707.95 Median $1,148.15 Typical High $1,737.80 | Professional | None | $707.95 | $1,148.15 | $1,737.80 |
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 $436.52 Median $436.52 Typical High $467.74 | Professional | 52 · Reduced service | $436.52 | $436.52 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $190.55 | Professional | 53 · Discontinued | $173.78 | $173.78 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $707.95 | Professional | 54 · Surgery only | $660.69 | $660.69 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $141.25 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $95.50 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $95.50 |
Where Virginia sits
The same service costs 3.8 times more in Wisconsin than in New York. 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· 42nd of 51
$912
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.