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 $691.83 Median $4,265.80 Typical High $9,332.54 | Facility | None | $691.83 | $4,265.80 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $1,862.09 Typical High $3,090.30 | Professional | None | $371.54 | $1,862.09 | $3,090.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $1,412.54 Typical High $2,344.23 | Professional | None | $323.59 | $1,412.54 | $2,344.23 |
CareFirst Setting Professional Modifier None Typical Low $338.84 Median $371.54 Typical High $489.78 | Professional | None | $338.84 | $371.54 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $776.25 Typical High $3,019.95 | Professional | None | $316.23 | $776.25 | $3,019.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,949.84 Median $2,290.87 Typical High $2,884.03 | Professional | None | $1,949.84 | $2,290.87 | $2,884.03 |
Medcost Setting Professional Modifier None Typical Low $457.09 Median $3,467.37 Typical High $3,467.37 | Professional | None | $457.09 | $3,467.37 | $3,467.37 |
Medcost Setting Facility Modifier None Typical Low $478.63 Median $602.56 Typical High $3,388.44 | Facility | None | $478.63 | $602.56 | $3,388.44 |
Medcost Setting Professional Modifier None Typical Low $338.84 Median $446.68 Typical High $2,570.40 | Professional | None | $338.84 | $446.68 | $2,570.40 |
Sentara Setting Facility Modifier None Typical Low $288.40 Median $524.81 Typical High $10,232.93 | Facility | None | $288.40 | $524.81 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $309.03 Median $2,454.71 Typical High $4,265.80 | Professional | None | $309.03 | $2,454.71 | $4,265.80 |
United Setting Facility Modifier None Typical Low $204.17 Median $1,023.29 Typical High $2,398.83 | Facility | None | $204.17 | $1,023.29 | $2,398.83 |
United Setting Professional Modifier None Typical Low $309.03 Median $977.24 Typical High $3,467.37 | Professional | None | $309.03 | $977.24 | $3,467.37 |
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 $186.21 Median $295.12 Typical High $1,202.26 | Professional | 52 · Reduced service | $186.21 | $295.12 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $120.23 Typical High $478.63 | Professional | 53 · Discontinued | $74.13 | $120.23 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $446.68 Typical High $1,819.70 | Professional | 54 · Surgery only | $275.42 | $446.68 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $89.13 Typical High $363.08 | Professional | 55 · Aftercare only | $56.23 | $89.13 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $60.26 Typical High $239.88 | Professional | 56 · Pre-op care only | $37.15 | $60.26 | $239.88 |
Where Virginia sits
The same service costs 5.5 times more in Washington 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· 32nd of 51
$1,413
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.