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 $128.82 Median $2,570.40 Typical High $9,332.54 | Facility | None | $128.82 | $2,570.40 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $169.82 Typical High $218.78 | Professional | None | $102.33 | $169.82 | $218.78 |
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 $87.10 Median $144.54 Typical High $213.80 | Professional | None | $87.10 | $144.54 | $213.80 |
CareFirst Setting Professional Modifier None Typical Low $91.20 Median $100.00 Typical High $117.49 | Professional | None | $91.20 | $100.00 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,479.11 Typical High $2,691.53 | Facility | None | $478.63 | $1,479.11 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $162.18 Typical High $229.09 | Professional | None | $91.20 | $162.18 | $229.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $186.21 Median $218.78 Typical High $275.42 | Professional | None | $186.21 | $218.78 | $275.42 |
Medcost Setting Professional Modifier None Typical Low $275.42 Median $346.74 Typical High $346.74 | Professional | None | $275.42 | $346.74 | $346.74 |
Medcost Setting Facility Modifier None Typical Low $102.33 Median $169.82 Typical High $275.42 | Facility | None | $102.33 | $169.82 | $275.42 |
Medcost Setting Professional Modifier None Typical Low $173.78 Median $234.42 Typical High $275.42 | Professional | None | $173.78 | $234.42 | $275.42 |
Sentara Setting Facility Modifier None Typical Low $102.33 Median $912.01 Typical High $8,709.64 | Facility | None | $102.33 | $912.01 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $151.36 Median $199.53 Typical High $288.40 | Professional | None | $151.36 | $199.53 | $288.40 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,011.87 Typical High $13,182.57 | Facility | None | $1,230.27 | $5,011.87 | $13,182.57 |
United Setting Professional Modifier None Typical Low $75.86 Median $141.25 Typical High $257.04 | Professional | None | $75.86 | $141.25 | $257.04 |
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 $51.29 Median $64.57 Typical High $107.15 | Professional | 52 · Reduced service | $51.29 | $64.57 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $25.70 Typical High $43.65 | Professional | 53 · Discontinued | $20.89 | $25.70 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $95.50 Typical High $162.18 | Professional | 54 · Surgery only | $77.62 | $95.50 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $19.05 Typical High $32.36 | Professional | 55 · Aftercare only | $15.49 | $19.05 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $12.88 Typical High $21.88 | Professional | 56 · Pre-op care only | $10.23 | $12.88 | $21.88 |
Where Virginia sits
The same service costs 3.6 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· 41st of 51
$151
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.