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 $213.80 Median $4,073.80 Typical High $10,000.00 | Facility | None | $213.80 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $213.80 Typical High $269.15 | Professional | None | $125.89 | $213.80 | $269.15 |
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 $104.71 Median $177.83 Typical High $269.15 | Professional | None | $104.71 | $177.83 | $269.15 |
CareFirst Setting Professional Modifier None Typical Low $109.65 Median $123.03 Typical High $144.54 | Professional | None | $109.65 | $123.03 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $741.31 Typical High $1,659.59 | Facility | None | $346.74 | $741.31 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $199.53 Typical High $281.84 | Professional | None | $107.15 | $199.53 | $281.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $234.42 Median $275.42 Typical High $363.08 | Professional | None | $234.42 | $275.42 | $363.08 |
Medcost Setting Professional Modifier None Typical Low $194.98 Median $245.47 Typical High $263.03 | Professional | None | $194.98 | $245.47 | $263.03 |
Medcost Setting Facility Modifier None Typical Low $125.89 Median $208.93 Typical High $354.81 | Facility | None | $125.89 | $208.93 | $354.81 |
Medcost Setting Professional Modifier None Typical Low $151.36 Median $204.17 Typical High $263.03 | Professional | None | $151.36 | $204.17 | $263.03 |
Sentara Setting Facility Modifier None Typical Low $89.13 Median $912.01 Typical High $3,630.78 | Facility | None | $89.13 | $912.01 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $134.90 Median $257.04 Typical High $371.54 | Professional | None | $134.90 | $257.04 | $371.54 |
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 $91.20 Median $162.18 Typical High $281.84 | Professional | None | $91.20 | $162.18 | $281.84 |
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 $63.10 Median $83.18 Typical High $134.90 | Professional | 52 · Reduced service | $63.10 | $83.18 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $33.11 Typical High $53.70 | Professional | 53 · Discontinued | $25.12 | $33.11 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $125.89 Typical High $204.17 | Professional | 54 · Surgery only | $95.50 | $125.89 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $25.12 Typical High $40.74 | Professional | 55 · Aftercare only | $19.05 | $25.12 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $16.60 Typical High $26.92 | Professional | 56 · Pre-op care only | $12.59 | $16.60 | $26.92 |
Where Virginia sits
The same service costs 3.8 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· 40th 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.