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 $1,230.27 Median $5,370.32 Typical High $14,125.38 | Facility | None | $1,230.27 | $5,370.32 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $165.96 Typical High $4,570.88 | Professional | None | $151.36 | $165.96 | $4,570.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,309.57 Median $8,709.64 Typical High $11,481.54 | Facility | None | $6,309.57 | $8,709.64 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $123.03 Median $147.91 Typical High $186.21 | Professional | None | $123.03 | $147.91 | $186.21 |
CareFirst Setting Professional Modifier None Typical Low $128.82 Median $141.25 Typical High $6,918.31 | Professional | None | $128.82 | $141.25 | $6,918.31 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $2,884.03 Typical High $6,025.60 | Facility | None | $524.81 | $2,884.03 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $181.97 Typical High $251.19 | Professional | None | $125.89 | $181.97 | $251.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $117.49 Median $141.25 Typical High $173.78 | Professional | None | $117.49 | $141.25 | $173.78 |
Medcost Setting Professional Modifier None Typical Low $213.80 Median $269.15 Typical High $269.15 | Professional | None | $213.80 | $269.15 | $269.15 |
Medcost Setting Facility Modifier None Typical Low $151.36 Median $208.93 Typical High $251.19 | Facility | None | $151.36 | $208.93 | $251.19 |
Medcost Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
Sentara Setting Facility Modifier None Typical Low $141.25 Median $912.01 Typical High $10,715.19 | Facility | None | $141.25 | $912.01 | $10,715.19 |
Sentara Setting Professional Modifier None Typical Low $141.25 Median $199.53 Typical High $10,232.93 | Professional | None | $141.25 | $199.53 | $10,232.93 |
United Setting Facility Modifier None Typical Low $2,570.40 Median $10,000.00 Typical High $25,118.86 | Facility | None | $2,570.40 | $10,000.00 | $25,118.86 |
United Setting Professional Modifier None Typical Low $123.03 Median $213.80 Typical High $302.00 | Professional | None | $123.03 | $213.80 | $302.00 |
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 $75.86 Median $75.86 Typical High $83.18 | Professional | 52 · Reduced service | $75.86 | $75.86 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $30.20 Typical High $33.11 | Professional | 53 · Discontinued | $30.20 | $30.20 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $114.82 Typical High $125.89 | Professional | 54 · Surgery only | $114.82 | $114.82 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $25.12 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $16.60 | Professional | 56 · Pre-op care only | $15.14 | $15.14 | $16.60 |
Where Virginia sits
The same service costs 17.8 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· 49th of 51
$174
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.