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 $190.55 Median $4,073.80 Typical High $10,000.00 | Facility | None | $190.55 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $323.59 Typical High $380.19 | Professional | None | $154.88 | $323.59 | $380.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $144.54 Median $173.78 Typical High $239.88 | Professional | None | $144.54 | $173.78 | $239.88 |
CareFirst Setting Professional Modifier None Typical Low $151.36 Median $165.96 Typical High $229.09 | Professional | None | $151.36 | $165.96 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $316.23 Typical High $524.81 | Professional | None | $151.36 | $316.23 | $524.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $363.08 Median $426.58 Typical High $524.81 | Professional | None | $363.08 | $426.58 | $524.81 |
Medcost Setting Professional Modifier None Typical Low $478.63 Median $602.56 Typical High $602.56 | Professional | None | $478.63 | $602.56 | $602.56 |
Medcost Setting Facility Modifier None Typical Low $234.42 Median $309.03 Typical High $616.60 | Facility | None | $234.42 | $309.03 | $616.60 |
Medcost Setting Professional Modifier None Typical Low $204.17 Median $331.13 Typical High $407.38 | Professional | None | $204.17 | $331.13 | $407.38 |
Sentara Setting Facility Modifier None Typical Low $147.91 Median $281.84 Typical High $10,232.93 | Facility | None | $147.91 | $281.84 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $338.84 Median $478.63 Typical High $870.96 | Professional | None | $338.84 | $478.63 | $870.96 |
United Setting Facility Modifier None Typical Low $204.17 Median $1,023.29 Typical High $2,398.83 | Facility | None | $204.17 | $1,023.29 | $2,398.83 |
United Setting Professional Modifier None Typical Low $151.36 Median $309.03 Typical High $616.60 | Professional | None | $151.36 | $309.03 | $616.60 |
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 $77.62 Median $125.89 Typical High $190.55 | Professional | 52 · Reduced service | $77.62 | $125.89 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $51.29 Typical High $75.86 | Professional | 53 · Discontinued | $30.90 | $51.29 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $190.55 Typical High $281.84 | Professional | 54 · Surgery only | $117.49 | $190.55 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $38.02 Typical High $56.23 | Professional | 55 · Aftercare only | $23.44 | $38.02 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $25.70 Typical High $38.02 | Professional | 56 · Pre-op care only | $15.49 | $25.70 | $38.02 |
Where Virginia sits
The same service costs 3.3 times more in Alaska than in Virginia. 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· 51st of 51
$204
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.