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 $144.54 Median $5,495.41 Typical High $14,125.38 | Facility | None | $144.54 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $144.54 Typical High $144.54 | Professional | None | $128.82 | $144.54 | $144.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $3,715.35 Typical High $6,456.54 | Facility | None | $1,445.44 | $3,715.35 | $6,456.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $141.25 Typical High $181.97 | Professional | None | $117.49 | $141.25 | $181.97 |
CareFirst Setting Professional Modifier None Typical Low $123.03 Median $138.04 Typical High $177.83 | Professional | None | $123.03 | $138.04 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,174.90 Typical High $3,019.95 | Facility | None | $512.86 | $1,174.90 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $141.25 Typical High $218.78 | Professional | None | $117.49 | $141.25 | $218.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $107.15 Median $128.82 Typical High $158.49 | Professional | None | $107.15 | $128.82 | $158.49 |
Medcost Setting Professional Modifier None Typical Low $181.97 Median $223.87 Typical High $223.87 | Professional | None | $181.97 | $223.87 | $223.87 |
Medcost Setting Facility Modifier None Typical Low $144.54 Median $165.96 Typical High $234.42 | Facility | None | $144.54 | $165.96 | $234.42 |
Medcost Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
Sentara Setting Facility Modifier None Typical Low $112.20 Median $912.01 Typical High $5,128.61 | Facility | None | $112.20 | $912.01 | $5,128.61 |
Sentara Setting Professional Modifier None Typical Low $117.49 Median $165.96 Typical High $1,288.25 | Professional | None | $117.49 | $165.96 | $1,288.25 |
United Setting Facility Modifier None Typical Low $436.52 Median $2,344.23 Typical High $6,309.57 | Facility | None | $436.52 | $2,344.23 | $6,309.57 |
United Setting Professional Modifier None Typical Low $104.71 Median $165.96 Typical High $239.88 | Professional | None | $104.71 | $165.96 | $239.88 |
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 $64.57 Median $72.44 Typical High $72.44 | Professional | 52 · Reduced service | $64.57 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $28.84 Typical High $28.84 | Professional | 53 · Discontinued | $25.70 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $107.15 Typical High $107.15 | Professional | 54 · Surgery only | $95.50 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $21.88 Typical High $21.88 | Professional | 55 · Aftercare only | $19.05 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $14.45 Typical High $14.45 | Professional | 56 · Pre-op care only | $12.88 | $14.45 | $14.45 |
Where Virginia sits
The same service costs 3.9 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· 43rd of 51
$151
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.