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 $138.04 Median $4,073.80 Typical High $10,000.00 | Facility | None | $138.04 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $245.47 Typical High $288.40 | Professional | None | $117.49 | $245.47 | $288.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,737.80 Median $2,398.83 Typical High $2,951.21 | Facility | None | $1,737.80 | $2,398.83 | $2,951.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $109.65 Median $131.83 Typical High $186.21 | Professional | None | $109.65 | $131.83 | $186.21 |
CareFirst Setting Professional Modifier None Typical Low $112.20 Median $125.89 Typical High $165.96 | Professional | None | $112.20 | $125.89 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $239.88 Typical High $398.11 | Professional | None | $114.82 | $239.88 | $398.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $245.47 Median $281.84 Typical High $363.08 | Professional | None | $245.47 | $281.84 | $363.08 |
Medcost Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | None | $630.96 | $630.96 | $630.96 |
Medcost Setting Facility Modifier None Typical Low $173.78 Median $223.87 Typical High $467.74 | Facility | None | $173.78 | $223.87 | $467.74 |
Medcost Setting Professional Modifier None Typical Low $245.47 Median $302.00 Typical High $338.84 | Professional | None | $245.47 | $302.00 | $338.84 |
Sentara Setting Facility Modifier None Typical Low $107.15 Median $229.09 Typical High $10,232.93 | Facility | None | $107.15 | $229.09 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $263.03 Median $331.13 Typical High $691.83 | Professional | None | $263.03 | $331.13 | $691.83 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $2,454.71 Typical High $4,466.84 | Facility | None | $1,174.90 | $2,454.71 | $4,466.84 |
United Setting Professional Modifier None Typical Low $114.82 Median $239.88 Typical High $457.09 | Professional | None | $114.82 | $239.88 | $457.09 |
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 $58.88 Median $100.00 Typical High $141.25 | Professional | 52 · Reduced service | $58.88 | $100.00 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $40.74 Typical High $57.54 | Professional | 53 · Discontinued | $23.44 | $40.74 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $151.36 Typical High $213.80 | Professional | 54 · Surgery only | $89.13 | $151.36 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $30.20 Typical High $42.66 | Professional | 55 · Aftercare only | $17.78 | $30.20 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $20.42 Typical High $28.84 | Professional | 56 · Pre-op care only | $11.75 | $20.42 | $28.84 |
Where Virginia sits
The same service costs 3.4 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
$155
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.