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 $281.84 Median $4,365.16 Typical High $12,302.69 | Facility | None | $281.84 | $4,365.16 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $281.84 Typical High $2,754.23 | Professional | None | $125.89 | $281.84 | $2,754.23 |
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 $107.15 Median $204.17 Typical High $302.00 | Professional | None | $107.15 | $204.17 | $302.00 |
CareFirst Setting Professional Modifier None Typical Low $104.71 Median $117.49 Typical High $977.24 | Professional | None | $104.71 | $117.49 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $831.76 Typical High $2,187.76 | Facility | None | $478.63 | $831.76 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $204.17 Typical High $346.74 | Professional | None | $107.15 | $204.17 | $346.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $93.33 Median $302.00 Typical High $371.54 | Professional | None | $93.33 | $302.00 | $371.54 |
Medcost Setting Professional Modifier None Typical Low $190.55 Median $239.88 Typical High $239.88 | Professional | None | $190.55 | $239.88 | $239.88 |
Medcost Setting Facility Modifier None Typical Low $125.89 Median $204.17 Typical High $457.09 | Facility | None | $125.89 | $204.17 | $457.09 |
Medcost Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
Sentara Setting Facility Modifier None Typical Low $102.33 Median $616.60 Typical High $2,951.21 | Facility | None | $102.33 | $616.60 | $2,951.21 |
Sentara Setting Professional Modifier None Typical Low $173.78 Median $316.23 Typical High $2,691.53 | Professional | None | $173.78 | $316.23 | $2,691.53 |
United Setting Facility Modifier None Typical Low $323.59 Median $1,445.44 Typical High $10,715.19 | Facility | None | $323.59 | $1,445.44 | $10,715.19 |
United Setting Professional Modifier None Typical Low $104.71 Median $204.17 Typical High $426.58 | Professional | None | $104.71 | $204.17 | $426.58 |
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 $61.66 Median $89.13 Typical High $154.88 | Professional | 52 · Reduced service | $61.66 | $89.13 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $35.48 Typical High $61.66 | Professional | 53 · Discontinued | $25.12 | $35.48 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $134.90 Typical High $229.09 | Professional | 54 · Surgery only | $93.33 | $134.90 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $26.92 Typical High $45.71 | Professional | 55 · Aftercare only | $18.62 | $26.92 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $17.78 Typical High $30.90 | Professional | 56 · Pre-op care only | $12.59 | $17.78 | $30.90 |
Where Virginia sits
The same service costs 4.3 times more in Alaska 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· 45th of 51
$234
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.