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 $407.38 Median $4,786.30 Typical High $10,000.00 | Facility | None | $407.38 | $4,786.30 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,000.00 Median $6,025.60 Typical High $7,244.36 | Facility | None | $1,000.00 | $6,025.60 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $331.13 Median $389.05 Typical High $467.74 | Professional | None | $331.13 | $389.05 | $467.74 |
CareFirst Setting Professional Modifier None Typical Low $338.84 Median $380.19 Typical High $446.68 | Professional | None | $338.84 | $380.19 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,000.00 Typical High $2,187.76 | Facility | None | $478.63 | $1,000.00 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $363.08 Typical High $588.84 | Professional | None | $338.84 | $363.08 | $588.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $302.00 Median $338.84 Typical High $588.84 | Professional | None | $302.00 | $338.84 | $588.84 |
Medcost Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $676.08 | Professional | None | $549.54 | $676.08 | $676.08 |
Medcost Setting Facility Modifier None Typical Low $407.38 Median $588.84 Typical High $676.08 | Facility | None | $407.38 | $588.84 | $676.08 |
Medcost Setting Professional Modifier None Typical Low $501.19 Median $537.03 Typical High $724.44 | Professional | None | $501.19 | $537.03 | $724.44 |
Sentara Setting Facility Modifier None Typical Low $380.19 Median $1,445.44 Typical High $8,709.64 | Facility | None | $380.19 | $1,445.44 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $371.54 Median $426.58 Typical High $645.65 | Professional | None | $371.54 | $426.58 | $645.65 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $4,897.79 Typical High $13,182.57 | Facility | None | $1,230.27 | $4,897.79 | $13,182.57 |
United Setting Professional Modifier None Typical Low $295.12 Median $363.08 Typical High $630.96 | Professional | None | $295.12 | $363.08 | $630.96 |
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 $204.17 Median $204.17 Typical High $204.17 | Professional | 52 · Reduced service | $204.17 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | 53 · Discontinued | $81.28 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $302.00 Typical High $309.03 | Professional | 54 · Surgery only | $302.00 | $302.00 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $61.66 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $40.74 |
Where Virginia sits
The same service costs 4.8 times more in Alaska than in Utah. 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· 40th of 51
$398
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.