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 $269.15 Median $4,073.80 Typical High $9,332.54 | Facility | None | $269.15 | $4,073.80 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $2,818.38 Typical High $3,715.35 | Professional | None | $257.04 | $2,818.38 | $3,715.35 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $7,413.10 Typical High $9,549.93 | Facility | None | $6,165.95 | $7,413.10 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $239.88 Median $851.14 Typical High $3,548.13 | Professional | None | $239.88 | $851.14 | $3,548.13 |
CareFirst Setting Professional Modifier None Typical Low $223.87 Median $251.19 Typical High $3,890.45 | Professional | None | $223.87 | $251.19 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $4,466.84 Typical High $8,128.31 | Facility | None | $524.81 | $4,466.84 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $2,187.76 Typical High $4,677.35 | Professional | None | $245.47 | $2,187.76 | $4,677.35 |
Kaiser Permanente Setting Professional Modifier None Typical Low $199.53 Median $3,162.28 Typical High $3,890.45 | Professional | None | $199.53 | $3,162.28 | $3,890.45 |
Medcost Setting Facility Modifier None Typical Low $269.15 Median $407.38 Typical High $5,370.32 | Facility | None | $269.15 | $407.38 | $5,370.32 |
Medcost Setting Professional Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $3,801.89 | Professional | None | $3,801.89 | $3,801.89 | $3,801.89 |
Sentara Setting Facility Modifier None Typical Low $245.47 Median $2,454.71 Typical High $11,481.54 | Facility | None | $245.47 | $2,454.71 | $11,481.54 |
Sentara Setting Professional Modifier None Typical Low $3,162.28 Median $4,073.80 Typical High $9,549.93 | Professional | None | $3,162.28 | $4,073.80 | $9,549.93 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $8,511.38 Typical High $20,417.38 | Facility | None | $1,995.26 | $8,511.38 | $20,417.38 |
United Setting Professional Modifier None Typical Low $218.78 Median $741.31 Typical High $6,165.95 | Professional | None | $218.78 | $741.31 | $6,165.95 |
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 $128.82 Median $245.47 Typical High $1,737.80 | Professional | 52 · Reduced service | $128.82 | $245.47 | $1,737.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $100.00 Typical High $707.95 | Professional | 53 · Discontinued | $51.29 | $100.00 | $707.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $371.54 Typical High $2,630.27 | Professional | 54 · Surgery only | $194.98 | $371.54 | $2,630.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $74.13 Typical High $524.81 | Professional | 55 · Aftercare only | $38.90 | $74.13 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $50.12 Typical High $354.81 | Professional | 56 · Pre-op care only | $25.70 | $50.12 | $354.81 |
Where Virginia sits
The same service costs 11.2 times more in Alaska than in Nebraska. 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· 31st of 51
$2,570
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.