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 $100.00 Median $144.54 Typical High $190.55 | Facility | None | $100.00 | $144.54 | $190.55 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $114.82 Typical High $186.21 | Professional | None | $100.00 | $114.82 | $186.21 |
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 $95.50 Median $114.82 Typical High $147.91 | Professional | None | $95.50 | $114.82 | $147.91 |
CareFirst Setting Professional Modifier None Typical Low $100.00 Median $112.20 Typical High $2,454.71 | Professional | None | $100.00 | $112.20 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $1,659.59 Typical High $3,311.31 | Facility | None | $346.74 | $1,659.59 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $120.23 Typical High $177.83 | Professional | None | $97.72 | $120.23 | $177.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $89.13 Median $107.15 Typical High $131.83 | Professional | None | $89.13 | $107.15 | $131.83 |
Medcost Setting Professional Modifier None Typical Low $158.49 Median $194.98 Typical High $194.98 | Professional | None | $158.49 | $194.98 | $194.98 |
Medcost Setting Facility Modifier None Typical Low $114.82 Median $141.25 Typical High $186.21 | Facility | None | $114.82 | $141.25 | $186.21 |
Medcost Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
Sentara Setting Facility Modifier None Typical Low $95.50 Median $912.01 Typical High $8,709.64 | Facility | None | $95.50 | $912.01 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $95.50 Median $134.90 Typical High $4,570.88 | Professional | None | $95.50 | $134.90 | $4,570.88 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,011.87 Typical High $13,182.57 | Facility | None | $1,230.27 | $5,011.87 | $13,182.57 |
United Setting Professional Modifier None Typical Low $85.11 Median $138.04 Typical High $208.93 | Professional | None | $85.11 | $138.04 | $208.93 |
4 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 $46.77 Median $57.54 Typical High $57.54 | Professional | 52 · Reduced service | $46.77 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $22.91 Typical High $22.91 | Professional | 53 · Discontinued | $18.62 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $17.38 Typical High $17.38 | Professional | 55 · Aftercare only | $14.13 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $11.48 Typical High $11.48 | Professional | 56 · Pre-op care only | $9.33 | $11.48 | $11.48 |
Where Virginia sits
The same service costs 7.9 times more in Kansas 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· 46th of 51
$120
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.