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 $562.34 Median $4,365.16 Typical High $10,000.00 | Facility | None | $562.34 | $4,365.16 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $562.34 Typical High $3,162.28 | Professional | None | $512.86 | $562.34 | $3,162.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,079.46 Median $8,128.31 Typical High $12,882.50 | Facility | None | $7,079.46 | $8,128.31 | $12,882.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
CareFirst Setting Professional Modifier None Typical Low $354.81 Median $812.83 Typical High $1,047.13 | Professional | None | $354.81 | $812.83 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $794.33 Typical High $5,495.41 | Facility | None | $501.19 | $794.33 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $549.54 Typical High $977.24 | Professional | None | $524.81 | $549.54 | $977.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $489.78 Median $575.44 Typical High $724.44 | Professional | None | $489.78 | $575.44 | $724.44 |
Medcost Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $851.14 | Facility | None | $562.34 | $562.34 | $851.14 |
Medcost Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
Sentara Setting Facility Modifier None Typical Low $354.81 Median $891.25 Typical High $2,754.23 | Facility | None | $354.81 | $891.25 | $2,754.23 |
Sentara Setting Professional Modifier None Typical Low $524.81 Median $776.25 Typical High $2,691.53 | Professional | None | $524.81 | $776.25 | $2,691.53 |
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 |
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 $245.47 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $245.47 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $97.72 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $416.87 Typical High $416.87 | Professional | 54 · Surgery only | $363.08 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $85.11 Typical High $85.11 | Professional | 55 · Aftercare only | $74.13 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $48.98 | $56.23 | $56.23 |
Where Virginia sits
The same service costs 134.9 times more in Oklahoma than in Hawaii. 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· 19th of 51
$676
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.