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 $436.52 Median $4,073.80 Typical High $10,000.00 | Facility | None | $436.52 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $389.05 Typical High $512.86 | Professional | None | $181.97 | $389.05 | $512.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,000.00 Median $3,630.78 Typical High $4,168.69 | Facility | None | $1,000.00 | $3,630.78 | $4,168.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $151.36 Median $331.13 Typical High $512.86 | Professional | None | $151.36 | $331.13 | $512.86 |
CareFirst Setting Professional Modifier None Typical Low $154.88 Median $169.82 Typical High $199.53 | Professional | None | $154.88 | $169.82 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $912.01 Typical High $1,737.80 | Facility | None | $346.74 | $912.01 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $338.84 Typical High $501.19 | Professional | None | $158.49 | $338.84 | $501.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $457.09 Median $537.03 Typical High $676.08 | Professional | None | $457.09 | $537.03 | $676.08 |
Medcost Setting Professional Modifier None Typical Low $478.63 Median $588.84 Typical High $588.84 | Professional | None | $478.63 | $588.84 | $588.84 |
Medcost Setting Facility Modifier None Typical Low $181.97 Median $302.00 Typical High $707.95 | Facility | None | $181.97 | $302.00 | $707.95 |
Medcost Setting Professional Modifier None Typical Low $229.09 Median $398.11 Typical High $489.78 | Professional | None | $229.09 | $398.11 | $489.78 |
Sentara Setting Facility Modifier None Typical Low $158.49 Median $912.01 Typical High $3,630.78 | Facility | None | $158.49 | $912.01 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $169.82 Median $478.63 Typical High $707.95 | Professional | None | $169.82 | $478.63 | $707.95 |
United Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $5,888.44 | Facility | None | $588.84 | $2,187.76 | $5,888.44 |
United Setting Professional Modifier None Typical Low $134.90 Median $295.12 Typical High $575.44 | Professional | None | $134.90 | $295.12 | $575.44 |
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 $91.20 Median $147.91 Typical High $257.04 | Professional | 52 · Reduced service | $91.20 | $147.91 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $58.88 Typical High $102.33 | Professional | 53 · Discontinued | $36.31 | $58.88 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $218.78 Typical High $389.05 | Professional | 54 · Surgery only | $134.90 | $218.78 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $44.67 Typical High $77.62 | Professional | 55 · Aftercare only | $26.92 | $44.67 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $29.51 Typical High $51.29 | Professional | 56 · Pre-op care only | $18.20 | $29.51 | $51.29 |
Where Virginia sits
The same service costs 4.5 times more in Alaska than in Washington, DC. 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· 42nd of 51
$324
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.