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 $199.53 Median $4,365.16 Typical High $14,125.38 | Facility | None | $199.53 | $4,365.16 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $199.53 Typical High $2,041.74 | Professional | None | $173.78 | $199.53 | $2,041.74 |
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 $165.96 Median $199.53 Typical High $257.04 | Professional | None | $165.96 | $199.53 | $257.04 |
CareFirst Setting Professional Modifier None Typical Low $173.78 Median $190.55 Typical High $691.83 | Professional | None | $173.78 | $190.55 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $371.54 Typical High $7,943.28 | Facility | None | $169.82 | $371.54 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $204.17 Typical High $309.03 | Professional | None | $169.82 | $204.17 | $309.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $151.36 Median $181.97 Typical High $223.87 | Professional | None | $151.36 | $181.97 | $223.87 |
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 $199.53 Median $251.19 Typical High $331.13 | Facility | None | $199.53 | $251.19 | $331.13 |
Medcost Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Sentara Setting Facility Modifier None Typical Low $158.49 Median $407.38 Typical High $2,454.71 | Facility | None | $158.49 | $407.38 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $165.96 Median $239.88 Typical High $933.25 | Professional | None | $165.96 | $239.88 | $933.25 |
United Setting Facility Modifier None Typical Low $100.00 Median $660.69 Typical High $2,041.74 | Facility | None | $100.00 | $660.69 | $2,041.74 |
United Setting Professional Modifier None Typical Low $147.91 Median $239.88 Typical High $363.08 | Professional | None | $147.91 | $239.88 | $363.08 |
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 $83.18 Median $100.00 Typical High $100.00 | Professional | 52 · Reduced service | $83.18 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $39.81 Typical High $39.81 | Professional | 53 · Discontinued | $33.11 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $151.36 Typical High $151.36 | Professional | 54 · Surgery only | $125.89 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $30.20 Typical High $30.20 | Professional | 55 · Aftercare only | $25.12 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $19.95 Typical High $19.95 | Professional | 56 · Pre-op care only | $16.60 | $19.95 | $19.95 |
Where Virginia sits
The same service costs 3.2 times more in Alaska than in Texas. 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· 42nd of 51
$209
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.