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 $154.88 Median $173.78 Typical High $4,570.88 | Professional | None | $154.88 | $173.78 | $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 $128.82 Median $151.36 Typical High $194.98 | Professional | None | $128.82 | $151.36 | $194.98 |
CareFirst Setting Professional Modifier None Typical Low $131.83 Median $147.91 Typical High $6,918.31 | Professional | None | $131.83 | $147.91 | $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 $131.83 Median $186.21 Typical High $257.04 | Professional | None | $131.83 | $186.21 | $257.04 |
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 $218.78 Median $275.42 Typical High $275.42 | Professional | None | $218.78 | $275.42 | $275.42 |
Medcost Setting Facility Modifier None Typical Low $154.88 Median $213.80 Typical High $257.04 | Facility | None | $154.88 | $213.80 | $257.04 |
Medcost Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
Sentara Setting Facility Modifier None Typical Low $144.54 Median $912.01 Typical High $10,715.19 | Facility | None | $144.54 | $912.01 | $10,715.19 |
Sentara Setting Professional Modifier None Typical Low $144.54 Median $204.17 Typical High $10,232.93 | Professional | None | $144.54 | $204.17 | $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 $125.89 Median $208.93 Typical High $309.03 | Professional | None | $125.89 | $208.93 | $309.03 |
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 $77.62 Median $77.62 Typical High $87.10 | Professional | 52 · Reduced service | $77.62 | $77.62 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $34.67 | Professional | 53 · Discontinued | $31.62 | $31.62 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $117.49 Typical High $128.82 | Professional | 54 · Surgery only | $117.49 | $117.49 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $23.44 Typical High $25.70 | Professional | 55 · Aftercare only | $23.44 | $23.44 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $17.38 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $17.38 |
Where Virginia sits
The same service costs 20.4 times more in Kansas 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
$178
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.