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 $229.09 Median $5,495.41 Typical High $14,125.38 | Facility | None | $229.09 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $229.09 Typical High $229.09 | Professional | None | $190.55 | $229.09 | $229.09 |
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 $190.55 Median $223.87 Typical High $288.40 | Professional | None | $190.55 | $223.87 | $288.40 |
CareFirst Setting Professional Modifier None Typical Low $194.98 Median $213.80 Typical High $2,238.72 | Professional | None | $194.98 | $213.80 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $173.78 Typical High $323.59 | Facility | None | $50.12 | $173.78 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $229.09 Typical High $346.74 | Professional | None | $190.55 | $229.09 | $346.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $169.82 Median $204.17 Typical High $251.19 | Professional | None | $169.82 | $204.17 | $251.19 |
Medcost Setting Professional Modifier None Typical Low $316.23 Median $389.05 Typical High $389.05 | Professional | None | $316.23 | $389.05 | $389.05 |
Medcost Setting Facility Modifier None Typical Low $229.09 Median $275.42 Typical High $371.54 | Facility | None | $229.09 | $275.42 | $371.54 |
Medcost Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
Sentara Setting Facility Modifier None Typical Low $190.55 Median $398.11 Typical High $2,454.71 | Facility | None | $190.55 | $398.11 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $190.55 Median $269.15 Typical High $1,023.29 | Professional | None | $190.55 | $269.15 | $1,023.29 |
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 $165.96 Median $269.15 Typical High $407.38 | Professional | None | $165.96 | $269.15 | $407.38 |
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 $95.50 Median $112.20 Typical High $112.20 | Professional | 52 · Reduced service | $95.50 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $45.71 Typical High $45.71 | Professional | 53 · Discontinued | $38.02 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $169.82 Typical High $169.82 | Professional | 54 · Surgery only | $141.25 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $33.88 Typical High $33.88 | Professional | 55 · Aftercare only | $28.18 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $22.91 Typical High $22.91 | Professional | 56 · Pre-op care only | $19.05 | $22.91 | $22.91 |
Where Virginia sits
The same service costs 3.2 times more in Alaska than in Utah. 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· 36th of 51
$240
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.