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 $134.90 Median $2,570.40 Typical High $9,332.54 | Facility | None | $134.90 | $2,570.40 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $239.88 Typical High $323.59 | Professional | None | $117.49 | $239.88 | $323.59 |
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 $107.15 Median $128.82 Typical High $181.97 | Professional | None | $107.15 | $128.82 | $181.97 |
CareFirst Setting Professional Modifier None Typical Low $112.20 Median $123.03 Typical High $162.18 | Professional | None | $112.20 | $123.03 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $229.09 Typical High $380.19 | Professional | None | $112.20 | $229.09 | $380.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $239.88 Median $275.42 Typical High $354.81 | Professional | None | $239.88 | $275.42 | $354.81 |
Medcost Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | None | $602.56 | $602.56 | $602.56 |
Medcost Setting Facility Modifier None Typical Low $165.96 Median $223.87 Typical High $446.68 | Facility | None | $165.96 | $223.87 | $446.68 |
Medcost Setting Professional Modifier None Typical Low $239.88 Median $288.40 Typical High $323.59 | Professional | None | $239.88 | $288.40 | $323.59 |
Sentara Setting Facility Modifier None Typical Low $104.71 Median $229.09 Typical High $10,232.93 | Facility | None | $104.71 | $229.09 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $257.04 Median $316.23 Typical High $660.69 | Professional | None | $257.04 | $316.23 | $660.69 |
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 $112.20 Median $229.09 Typical High $446.68 | Professional | None | $112.20 | $229.09 | $446.68 |
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 $97.72 Typical High $138.04 | Professional | 52 · Reduced service | $58.88 | $97.72 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $38.90 Typical High $54.95 | Professional | 53 · Discontinued | $23.44 | $38.90 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $147.91 Typical High $208.93 | Professional | 54 · Surgery only | $87.10 | $147.91 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $29.51 Typical High $41.69 | Professional | 55 · Aftercare only | $17.38 | $29.51 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $19.50 Typical High $27.54 | Professional | 56 · Pre-op care only | $11.75 | $19.50 | $27.54 |
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
$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.