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 $467.74 Median $7,413.10 Typical High $11,481.54 | Facility | None | $467.74 | $7,413.10 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
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 $380.19 Median $446.68 Typical High $524.81 | Professional | None | $380.19 | $446.68 | $524.81 |
CareFirst Setting Professional Modifier None Typical Low $389.05 Median $426.58 Typical High $512.86 | Professional | None | $389.05 | $426.58 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $4,365.16 Typical High $8,709.64 | Facility | None | $1,348.96 | $4,365.16 | $8,709.64 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $416.87 Typical High $630.96 | Professional | None | $389.05 | $416.87 | $630.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $346.74 Median $389.05 Typical High $676.08 | Professional | None | $346.74 | $389.05 | $676.08 |
Medcost Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $707.95 | Professional | None | $562.34 | $707.95 | $707.95 |
Medcost Setting Facility Modifier None Typical Low $467.74 Median $602.56 Typical High $776.25 | Facility | None | $467.74 | $602.56 | $776.25 |
Medcost Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $562.34 | Professional | None | $416.87 | $457.09 | $562.34 |
Sentara Setting Facility Modifier None Typical Low $398.11 Median $1,862.09 Typical High $10,232.93 | Facility | None | $398.11 | $1,862.09 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $407.38 Median $489.78 Typical High $707.95 | Professional | None | $407.38 | $489.78 | $707.95 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $6,760.83 Typical High $17,378.01 | Facility | None | $1,548.82 | $6,760.83 | $17,378.01 |
United Setting Professional Modifier None Typical Low $338.84 Median $398.11 Typical High $707.95 | Professional | None | $338.84 | $398.11 | $707.95 |
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 $229.09 Median $229.09 Typical High $234.42 | Professional | 52 · Reduced service | $229.09 | $229.09 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | 53 · Discontinued | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $346.74 Typical High $354.81 | Professional | 54 · Surgery only | $346.74 | $346.74 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $70.79 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $46.77 |
Where Virginia sits
The same service costs 4.5 times more in Alaska than in Texas. 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· 38th of 51
$447
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.