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 $223.87 Median $5,370.32 Typical High $14,125.38 | Facility | None | $223.87 | $5,370.32 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $223.87 Typical High $3,235.94 | Professional | None | $194.98 | $223.87 | $3,235.94 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $7,413.10 Typical High $9,549.93 | Facility | None | $6,165.95 | $7,413.10 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $173.78 Median $208.93 Typical High $269.15 | Professional | None | $173.78 | $208.93 | $269.15 |
CareFirst Setting Professional Modifier None Typical Low $194.98 Median $213.80 Typical High $5,623.41 | Professional | None | $194.98 | $213.80 | $5,623.41 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $2,691.53 Typical High $5,370.32 | Facility | None | $707.95 | $2,691.53 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $229.09 Typical High $354.81 | Professional | None | $181.97 | $229.09 | $354.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $151.36 Median $177.83 Typical High $229.09 | Professional | None | $151.36 | $177.83 | $229.09 |
Medcost Setting Facility Modifier None Typical Low $223.87 Median $251.19 Typical High $371.54 | Facility | None | $223.87 | $251.19 | $371.54 |
Medcost Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
Sentara Setting Facility Modifier None Typical Low $177.83 Median $933.25 Typical High $10,232.93 | Facility | None | $177.83 | $933.25 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $190.55 Median $257.04 Typical High $7,413.10 | Professional | None | $190.55 | $257.04 | $7,413.10 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $8,511.38 Typical High $20,417.38 | Facility | None | $1,995.26 | $8,511.38 | $20,417.38 |
United Setting Professional Modifier None Typical Low $165.96 Median $263.03 Typical High $407.38 | Professional | None | $165.96 | $263.03 | $407.38 |
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 $97.72 Median $112.20 Typical High $112.20 | Professional | 52 · Reduced service | $97.72 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $44.67 Typical High $44.67 | Professional | 53 · Discontinued | $38.90 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $169.82 Typical High $169.82 | Professional | 54 · Surgery only | $144.54 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $33.88 Typical High $33.88 | Professional | 55 · Aftercare only | $28.84 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $22.39 Typical High $22.39 | Professional | 56 · Pre-op care only | $19.50 | $22.39 | $22.39 |
Where Virginia sits
The same service costs 10.2 times more in Oklahoma 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· 47th of 51
$224
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.