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 $812.83 Median $4,365.16 Typical High $14,125.38 | Facility | None | $812.83 | $4,365.16 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $144.54 Typical High $3,801.89 | Professional | None | $128.82 | $144.54 | $3,801.89 |
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 $109.65 Median $131.83 Typical High $165.96 | Professional | None | $109.65 | $131.83 | $165.96 |
CareFirst Setting Professional Modifier None Typical Low $112.20 Median $125.89 Typical High $19,952.62 | Professional | None | $112.20 | $125.89 | $19,952.62 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $1,949.84 Typical High $3,890.45 | Facility | None | $346.74 | $1,949.84 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $154.88 Typical High $208.93 | Professional | None | $114.82 | $154.88 | $208.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $100.00 Median $114.82 Typical High $147.91 | Professional | None | $100.00 | $114.82 | $147.91 |
Medcost Setting Professional Modifier None Typical Low $173.78 Median $213.80 Typical High $213.80 | Professional | None | $173.78 | $213.80 | $213.80 |
Medcost Setting Facility Modifier None Typical Low $128.82 Median $169.82 Typical High $213.80 | Facility | None | $128.82 | $169.82 | $213.80 |
Medcost Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
Sentara Setting Facility Modifier None Typical Low $104.71 Median $912.01 Typical High $10,232.93 | Facility | None | $104.71 | $912.01 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $104.71 Median $169.82 Typical High $8,511.38 | Professional | None | $104.71 | $169.82 | $8,511.38 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $6,760.83 Typical High $17,378.01 | Facility | None | $1,548.82 | $6,760.83 | $17,378.01 |
United Setting Professional Modifier None Typical Low $102.33 Median $173.78 Typical High $251.19 | Professional | None | $102.33 | $173.78 | $251.19 |
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 $64.57 Median $64.57 Typical High $72.44 | Professional | 52 · Reduced service | $64.57 | $64.57 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $25.70 Typical High $28.84 | Professional | 53 · Discontinued | $25.70 | $25.70 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $97.72 Typical High $109.65 | Professional | 54 · Surgery only | $97.72 | $97.72 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $19.50 Typical High $21.88 | Professional | 55 · Aftercare only | $19.50 | $19.50 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $12.88 Typical High $14.45 | Professional | 56 · Pre-op care only | $12.88 | $12.88 | $14.45 |
Where Virginia sits
The same service costs 12.9 times more in Arkansas 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· 48th of 51
$151
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.