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 $467.74 Median $4,073.80 Typical High $14,125.38 | Facility | None | $467.74 | $4,073.80 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $467.74 Typical High $1,023.29 | Professional | None | $97.72 | $467.74 | $1,023.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,754.40 Median $8,317.64 Typical High $11,481.54 | Facility | None | $5,754.40 | $8,317.64 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $77.62 Median $213.80 Typical High $467.74 | Professional | None | $77.62 | $213.80 | $467.74 |
CareFirst Setting Professional Modifier None Typical Low $75.86 Median $85.11 Typical High $1,995.26 | Professional | None | $75.86 | $85.11 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $575.44 Typical High $2,691.53 | Facility | None | $346.74 | $575.44 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $257.04 Typical High $616.60 | Professional | None | $81.28 | $257.04 | $616.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $70.79 Median $426.58 Typical High $524.81 | Professional | None | $70.79 | $426.58 | $524.81 |
Medcost Setting Facility Modifier None Typical Low $104.71 Median $169.82 Typical High $758.58 | Facility | None | $104.71 | $169.82 | $758.58 |
Medcost Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
Sentara Setting Facility Modifier None Typical Low $89.13 Median $616.60 Typical High $2,951.21 | Facility | None | $89.13 | $616.60 | $2,951.21 |
Sentara Setting Professional Modifier None Typical Low $426.58 Median $562.34 Typical High $2,951.21 | Professional | None | $426.58 | $562.34 | $2,951.21 |
United Setting Facility Modifier None Typical Low $323.59 Median $1,412.54 Typical High $10,715.19 | Facility | None | $323.59 | $1,412.54 | $10,715.19 |
United Setting Professional Modifier None Typical Low $89.13 Median $269.15 Typical High $776.25 | Professional | None | $89.13 | $269.15 | $776.25 |
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 $48.98 Median $91.20 Typical High $251.19 | Professional | 52 · Reduced service | $48.98 | $91.20 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $37.15 Typical High $100.00 | Professional | 53 · Discontinued | $19.50 | $37.15 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $138.04 Typical High $380.19 | Professional | 54 · Surgery only | $74.13 | $138.04 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $27.54 Typical High $75.86 | Professional | 55 · Aftercare only | $14.79 | $27.54 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $18.62 Typical High $50.12 | Professional | 56 · Pre-op care only | $9.77 | $18.62 | $50.12 |
Where Virginia sits
The same service costs 7.8 times more in Oklahoma than in Nebraska. 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· 44th of 51
$372
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.