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 $162.18 Median $4,073.80 Typical High $10,000.00 | Facility | None | $162.18 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $162.18 Typical High $2,238.72 | Professional | None | $123.03 | $162.18 | $2,238.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $2,398.83 Typical High $2,951.21 | Facility | None | $1,698.24 | $2,398.83 | $2,951.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $141.25 Median $165.96 Typical High $208.93 | Professional | None | $141.25 | $165.96 | $208.93 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $89.13 Median $104.71 Typical High $131.83 | Professional | 62 · Two surgeons | $89.13 | $104.71 | $131.83 |
CareFirst Setting Professional Modifier None Typical Low $114.82 Median $128.82 Typical High $776.25 | Professional | None | $114.82 | $128.82 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $630.96 Typical High $1,621.81 | Facility | None | $346.74 | $630.96 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $165.96 Typical High $263.03 | Professional | None | $138.04 | $165.96 | $263.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $154.88 Typical High $190.55 | Professional | None | $128.82 | $154.88 | $190.55 |
Medcost Setting Facility Modifier None Typical Low $162.18 Median $194.98 Typical High $251.19 | Facility | None | $162.18 | $194.98 | $251.19 |
Medcost Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
Sentara Setting Facility Modifier None Typical Low $125.89 Median $616.60 Typical High $2,951.21 | Facility | None | $125.89 | $616.60 | $2,951.21 |
Sentara Setting Professional Modifier None Typical Low $134.90 Median $190.55 Typical High $1,737.80 | Professional | None | $134.90 | $190.55 | $1,737.80 |
United Setting Facility Modifier None Typical Low $323.59 Median $1,445.44 Typical High $3,630.78 | Facility | None | $323.59 | $1,445.44 | $3,630.78 |
United Setting Professional Modifier None Typical Low $112.20 Median $162.18 Typical High $281.84 | Professional | None | $112.20 | $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 $61.66 Median $81.28 Typical High $81.28 | Professional | 52 · Reduced service | $61.66 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $32.36 Typical High $32.36 | Professional | 53 · Discontinued | $24.55 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $123.03 Typical High $123.03 | Professional | 54 · Surgery only | $93.33 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $24.55 Typical High $24.55 | Professional | 55 · Aftercare only | $18.62 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $16.22 Typical High $16.22 | Professional | 56 · Pre-op care only | $12.30 | $16.22 | $16.22 |
Where Virginia sits
The same service costs 4.3 times more in Alaska than in New York. 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· 47th of 51
$174
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.