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 $218.78 Median $3,981.07 Typical High $9,332.54 | Facility | None | $218.78 | $3,981.07 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $218.78 Typical High $416.87 | Professional | None | $141.25 | $218.78 | $416.87 |
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 $120.23 Median $186.21 Typical High $269.15 | Professional | None | $120.23 | $186.21 | $269.15 |
CareFirst Setting Professional Modifier None Typical Low $120.23 Median $131.83 Typical High $2,454.71 | Professional | None | $120.23 | $131.83 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $812.83 Typical High $1,659.59 | Facility | None | $346.74 | $812.83 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $199.53 Typical High $309.03 | Professional | None | $123.03 | $199.53 | $309.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $102.33 Median $239.88 Typical High $295.12 | Professional | None | $102.33 | $239.88 | $295.12 |
Medcost Setting Professional Modifier None Typical Low $229.09 Median $288.40 Typical High $288.40 | Professional | None | $229.09 | $288.40 | $288.40 |
Medcost Setting Facility Modifier None Typical Low $141.25 Median $218.78 Typical High $363.08 | Facility | None | $141.25 | $218.78 | $363.08 |
Medcost Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
Sentara Setting Facility Modifier None Typical Low $102.33 Median $912.01 Typical High $3,630.78 | Facility | None | $102.33 | $912.01 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $181.97 Median $257.04 Typical High $2,137.96 | Professional | None | $181.97 | $257.04 | $2,137.96 |
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 $107.15 Median $190.55 Typical High $346.74 | Professional | None | $107.15 | $190.55 | $346.74 |
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 $69.18 Median $91.20 Typical High $123.03 | Professional | 52 · Reduced service | $69.18 | $91.20 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $36.31 Typical High $48.98 | Professional | 53 · Discontinued | $28.18 | $36.31 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $138.04 Typical High $181.97 | Professional | 54 · Surgery only | $104.71 | $138.04 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $27.54 Typical High $36.31 | Professional | 55 · Aftercare only | $20.89 | $27.54 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $18.20 Typical High $24.55 | Professional | 56 · Pre-op care only | $14.13 | $18.20 | $24.55 |
Where Virginia sits
The same service costs 4.0 times more in Alaska than in Kentucky. 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· 44th of 51
$204
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.