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 $154.88 Median $4,073.80 Typical High $10,000.00 | Facility | None | $154.88 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $141.25 Typical High $208.93 | Professional | None | $72.44 | $141.25 | $208.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $3,715.35 Typical High $4,265.80 | Facility | None | $2,884.03 | $3,715.35 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $61.66 Median $134.90 Typical High $204.17 | Professional | None | $61.66 | $134.90 | $204.17 |
CareFirst Setting Professional Modifier None Typical Low $61.66 Median $69.18 Typical High $81.28 | Professional | None | $61.66 | $69.18 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $281.84 Typical High $2,691.53 | Facility | None | $147.91 | $281.84 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $141.25 Typical High $199.53 | Professional | None | $64.57 | $141.25 | $199.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $177.83 Median $213.80 Typical High $263.03 | Professional | None | $177.83 | $213.80 | $263.03 |
Medcost Setting Professional Modifier None Typical Low $223.87 Median $275.42 Typical High $275.42 | Professional | None | $223.87 | $275.42 | $275.42 |
Medcost Setting Facility Modifier None Typical Low $72.44 Median $120.23 Typical High $251.19 | Facility | None | $72.44 | $120.23 | $251.19 |
Medcost Setting Professional Modifier None Typical Low $138.04 Median $151.36 Typical High $223.87 | Professional | None | $138.04 | $151.36 | $223.87 |
Sentara Setting Facility Modifier None Typical Low $72.44 Median $891.25 Typical High $3,630.78 | Facility | None | $72.44 | $891.25 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $134.90 Median $162.18 Typical High $263.03 | Professional | None | $134.90 | $162.18 | $263.03 |
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 $53.70 Median $120.23 Typical High $218.78 | Professional | None | $53.70 | $120.23 | $218.78 |
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 $36.31 Median $52.48 Typical High $104.71 | Professional | 52 · Reduced service | $36.31 | $52.48 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $20.89 Typical High $41.69 | Professional | 53 · Discontinued | $14.45 | $20.89 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $79.43 Typical High $158.49 | Professional | 54 · Surgery only | $54.95 | $79.43 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $15.85 Typical High $31.62 | Professional | 55 · Aftercare only | $10.96 | $15.85 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $10.47 Typical High $20.89 | Professional | 56 · Pre-op care only | $7.24 | $10.47 | $20.89 |
Where Virginia sits
The same service costs 3.7 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· 39th of 51
$135
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.