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 $257.04 Median $4,786.30 Typical High $14,125.38 | Facility | None | $257.04 | $4,786.30 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $257.04 Typical High $389.05 | Professional | None | $181.97 | $257.04 | $389.05 |
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 $190.55 Median $234.42 Typical High $269.15 | Professional | None | $190.55 | $234.42 | $269.15 |
CareFirst Setting Professional Modifier None Typical Low $199.53 Median $223.87 Typical High $263.03 | Professional | None | $199.53 | $223.87 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $323.59 Typical High $1,621.81 | Facility | None | $165.96 | $323.59 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $263.03 Typical High $380.19 | Professional | None | $190.55 | $263.03 | $380.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $275.42 Median $323.59 Typical High $398.11 | Professional | None | $275.42 | $323.59 | $398.11 |
Medcost Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $588.84 | Professional | None | $467.74 | $467.74 | $588.84 |
Medcost Setting Facility Modifier None Typical Low $181.97 Median $269.15 Typical High $512.86 | Facility | None | $181.97 | $269.15 | $512.86 |
Medcost Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
Sentara Setting Facility Modifier None Typical Low $204.17 Median $616.60 Typical High $2,951.21 | Facility | None | $204.17 | $616.60 | $2,951.21 |
Sentara Setting Professional Modifier None Typical Low $295.12 Median $354.81 Typical High $1,737.80 | Professional | None | $295.12 | $354.81 | $1,737.80 |
United Setting Facility Modifier None Typical Low $323.59 Median $1,412.54 Typical High $3,630.78 | Facility | None | $323.59 | $1,412.54 | $3,630.78 |
United Setting Professional Modifier None Typical Low $165.96 Median $251.19 Typical High $446.68 | Professional | None | $165.96 | $251.19 | $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 $91.20 Median $128.82 Typical High $173.78 | Professional | 52 · Reduced service | $91.20 | $128.82 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $51.29 Typical High $69.18 | Professional | 53 · Discontinued | $36.31 | $51.29 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $194.98 Typical High $263.03 | Professional | 54 · Surgery only | $138.04 | $194.98 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $38.90 Typical High $52.48 | Professional | 55 · Aftercare only | $27.54 | $38.90 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $25.70 Typical High $34.67 | Professional | 56 · Pre-op care only | $18.20 | $25.70 | $34.67 |
Where Virginia sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 47th of 51
$257
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.