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 $3,801.89 Median $5,495.41 Typical High $14,125.38 | Facility | None | $3,801.89 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $4,897.79 | Professional | None | $4,073.80 | $4,073.80 | $4,897.79 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $6,456.54 Typical High $7,244.36 | Facility | None | $4,677.35 | $6,456.54 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,570.40 Median $3,090.30 Typical High $3,801.89 | Professional | None | $2,570.40 | $3,090.30 | $3,801.89 |
CareFirst Setting Professional Modifier None Typical Low $3,548.13 Median $4,073.80 Typical High $6,760.83 | Professional | None | $3,548.13 | $4,073.80 | $6,760.83 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,819.70 Typical High $3,311.31 | Facility | None | $512.86 | $1,819.70 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $3,981.07 Median $4,365.16 Typical High $7,413.10 | Professional | None | $3,981.07 | $4,365.16 | $7,413.10 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,890.45 Median $4,677.35 Typical High $5,754.40 | Professional | None | $3,890.45 | $4,677.35 | $5,754.40 |
Medcost Setting Facility Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $6,165.95 | Facility | None | $4,073.80 | $4,073.80 | $6,165.95 |
Medcost Setting Professional Modifier None Typical Low $5,370.32 Median $5,370.32 Typical High $5,370.32 | Professional | None | $5,370.32 | $5,370.32 | $5,370.32 |
Sentara Setting Facility Modifier None Typical Low $1,023.29 Median $5,495.41 Typical High $11,481.54 | Facility | None | $1,023.29 | $5,495.41 | $11,481.54 |
Sentara Setting Professional Modifier None Typical Low $3,981.07 Median $6,025.60 Typical High $10,232.93 | Professional | None | $3,981.07 | $6,025.60 | $10,232.93 |
United Setting Facility Modifier None Typical Low $436.52 Median $2,344.23 Typical High $6,606.93 | Facility | None | $436.52 | $2,344.23 | $6,606.93 |
United Setting Professional Modifier None Typical Low $3,235.94 Median $5,248.07 Typical High $7,943.28 | Professional | None | $3,235.94 | $5,248.07 | $7,943.28 |
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 $1,995.26 Median $1,995.26 Typical High $2,454.71 | Professional | 52 · Reduced service | $1,995.26 | $1,995.26 | $2,454.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $812.83 Median $812.83 Typical High $977.24 | Professional | 53 · Discontinued | $812.83 | $812.83 | $977.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,019.95 Median $3,019.95 Typical High $3,715.35 | Professional | 54 · Surgery only | $3,019.95 | $3,019.95 | $3,715.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $602.56 Median $602.56 Typical High $741.31 | Professional | 55 · Aftercare only | $602.56 | $602.56 | $741.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $407.38 Median $407.38 Typical High $489.78 | Professional | 56 · Pre-op care only | $407.38 | $407.38 | $489.78 |
Where Virginia sits
The same service costs 4.4 times more in Alaska than in Arkansas. 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· 48th of 51
$3,388
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.