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 $288.40 Median $3,467.37 Typical High $9,332.54 | Facility | None | $288.40 | $3,467.37 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $1,122.02 Typical High $2,290.87 | Professional | None | $269.15 | $1,122.02 | $2,290.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $229.09 Median $977.24 Typical High $1,584.89 | Professional | None | $229.09 | $977.24 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $338.84 Median $1,445.44 Typical High $2,344.23 | Professional | 50 · Both sides | $338.84 | $1,445.44 | $2,344.23 |
CareFirst Setting Professional Modifier None Typical Low $223.87 Median $245.47 Typical High $346.74 | Professional | None | $223.87 | $245.47 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $575.44 Typical High $1,949.84 | Professional | None | $223.87 | $575.44 | $1,949.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,174.90 Median $1,380.38 Typical High $1,737.80 | Professional | None | $1,174.90 | $1,380.38 | $1,737.80 |
Medcost Setting Professional Modifier None Typical Low $346.74 Median $2,089.30 Typical High $2,089.30 | Professional | None | $346.74 | $2,089.30 | $2,089.30 |
Medcost Setting Facility Modifier None Typical Low $363.08 Median $436.52 Typical High $2,398.83 | Facility | None | $363.08 | $436.52 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $269.15 Median $1,148.15 Typical High $1,548.82 | Professional | None | $269.15 | $1,148.15 | $1,548.82 |
Sentara Setting Facility Modifier None Typical Low $208.93 Median $371.54 Typical High $10,232.93 | Facility | None | $208.93 | $371.54 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $234.42 Median $1,584.89 Typical High $3,019.95 | Professional | None | $234.42 | $1,584.89 | $3,019.95 |
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 $223.87 Median $707.95 Typical High $2,344.23 | Professional | None | $223.87 | $707.95 | $2,344.23 |
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 $134.90 Median $208.93 Typical High $831.76 | Professional | 52 · Reduced service | $134.90 | $208.93 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $85.11 Typical High $338.84 | Professional | 53 · Discontinued | $53.70 | $85.11 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $316.23 Typical High $1,258.93 | Professional | 54 · Surgery only | $204.17 | $316.23 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $63.10 Typical High $251.19 | Professional | 55 · Aftercare only | $40.74 | $63.10 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $41.69 Typical High $169.82 | Professional | 56 · Pre-op care only | $26.92 | $41.69 | $169.82 |
Where Virginia sits
The same service costs 5.8 times more in Washington than in Hawaii. 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· 28th of 51
$1,000
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.