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 $123.03 Median $4,365.16 Typical High $14,125.38 | Facility | None | $123.03 | $4,365.16 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $123.03 Typical High $2,570.40 | Professional | None | $112.20 | $123.03 | $2,570.40 |
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 $102.33 Median $123.03 Typical High $154.88 | Professional | None | $102.33 | $123.03 | $154.88 |
CareFirst Setting Professional Modifier None Typical Low $107.15 Median $120.23 Typical High $691.83 | Professional | None | $107.15 | $120.23 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $501.19 Typical High $1,621.81 | Facility | None | $346.74 | $501.19 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $123.03 Typical High $190.55 | Professional | None | $102.33 | $123.03 | $190.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $100.00 Median $120.23 Typical High $147.91 | Professional | None | $100.00 | $120.23 | $147.91 |
Medcost Setting Professional Modifier None Typical Low $138.04 Median $169.82 Typical High $169.82 | Professional | None | $138.04 | $169.82 | $169.82 |
Medcost Setting Facility Modifier None Typical Low $123.03 Median $144.54 Typical High $199.53 | Facility | None | $123.03 | $144.54 | $199.53 |
Medcost Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
Sentara Setting Facility Modifier None Typical Low $97.72 Median $616.60 Typical High $2,951.21 | Facility | None | $97.72 | $616.60 | $2,951.21 |
Sentara Setting Professional Modifier None Typical Low $104.71 Median $141.25 Typical High $1,737.80 | Professional | None | $104.71 | $141.25 | $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 $87.10 Median $131.83 Typical High $204.17 | Professional | None | $87.10 | $131.83 | $204.17 |
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 $54.95 Median $61.66 Typical High $61.66 | Professional | 52 · Reduced service | $54.95 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $24.55 Typical High $24.55 | Professional | 53 · Discontinued | $21.88 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $91.20 Typical High $91.20 | Professional | 54 · Surgery only | $83.18 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $18.20 Typical High $18.20 | Professional | 55 · Aftercare only | $16.60 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $12.30 Typical High $12.30 | Professional | 56 · Pre-op care only | $10.96 | $12.30 | $12.30 |
Where Virginia sits
The same service costs 4.4 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· 45th of 51
$129
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.