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 $154.88 Median $4,073.80 Typical High $10,000.00 | Facility | None | $154.88 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $190.55 Typical High $199.53 | Professional | None | $134.90 | $190.55 | $199.53 |
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 $125.89 Median $151.36 Typical High $181.97 | Professional | None | $125.89 | $151.36 | $181.97 |
CareFirst Setting Professional Modifier None Typical Low $128.82 Median $141.25 Typical High $165.96 | Professional | None | $128.82 | $141.25 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $128.82 Typical High $1,230.27 | Facility | None | $50.12 | $128.82 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $173.78 Typical High $269.15 | Professional | None | $123.03 | $173.78 | $269.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $181.97 Median $218.78 Typical High $275.42 | Professional | None | $181.97 | $218.78 | $275.42 |
Medcost Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
Medcost Setting Facility Modifier None Typical Low $154.88 Median $199.53 Typical High $323.59 | Facility | None | $154.88 | $199.53 | $323.59 |
Medcost Setting Professional Modifier None Typical Low $134.90 Median $151.36 Typical High $234.42 | Professional | None | $134.90 | $151.36 | $234.42 |
Sentara Setting Facility Modifier None Typical Low $131.83 Median $616.60 Typical High $2,951.21 | Facility | None | $131.83 | $616.60 | $2,951.21 |
Sentara Setting Professional Modifier None Typical Low $181.97 Median $223.87 Typical High $426.58 | Professional | None | $181.97 | $223.87 | $426.58 |
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 $97.72 Median $158.49 Typical High $302.00 | Professional | None | $97.72 | $158.49 | $302.00 |
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 $67.61 Median $81.28 Typical High $100.00 | Professional | 52 · Reduced service | $67.61 | $81.28 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $33.11 Typical High $39.81 | Professional | 53 · Discontinued | $26.92 | $33.11 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $123.03 Typical High $147.91 | Professional | 54 · Surgery only | $102.33 | $123.03 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $24.55 Typical High $30.20 | Professional | 55 · Aftercare only | $20.42 | $24.55 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $16.22 Typical High $19.95 | Professional | 56 · Pre-op care only | $13.49 | $16.22 | $19.95 |
Where Virginia sits
The same service costs 3.6 times more in Alaska than in Kentucky. 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· 48th of 51
$158
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.