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 $478.63 Median $478.63 Typical High $489.78 | Facility | None | $478.63 | $478.63 | $489.78 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $489.78 Typical High $489.78 | Professional | None | $478.63 | $489.78 | $489.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $478.63 Median $562.34 Typical High $676.08 | Professional | None | $478.63 | $562.34 | $676.08 |
CareFirst Setting Professional Modifier None Typical Low $537.03 Median $602.56 Typical High $691.83 | Professional | None | $537.03 | $602.56 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,318.26 | Facility | None | $1,148.15 | $1,148.15 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $524.81 Typical High $707.95 | Professional | None | $467.74 | $524.81 | $707.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $524.81 Median $588.84 Typical High $776.25 | Professional | None | $524.81 | $588.84 | $776.25 |
Medcost Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $676.08 | Professional | None | $549.54 | $676.08 | $676.08 |
Medcost Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $831.76 | Facility | None | $645.65 | $645.65 | $831.76 |
Medcost Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $524.81 | Professional | None | $354.81 | $354.81 | $524.81 |
Sentara Setting Facility Modifier None Typical Low $398.11 Median $660.69 Typical High $10,232.93 | Facility | None | $398.11 | $660.69 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $467.74 Median $512.86 Typical High $776.25 | Professional | None | $467.74 | $512.86 | $776.25 |
United Setting Professional Modifier None Typical Low $338.84 Median $426.58 Typical High $724.44 | Professional | None | $338.84 | $426.58 | $724.44 |
4 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 $239.88 Median $245.47 Typical High $245.47 | Professional | 52 · Reduced service | $239.88 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 53 · Discontinued | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $48.98 Typical High $48.98 | Professional | 56 · Pre-op care only | $47.86 | $48.98 | $48.98 |
Where Virginia sits
The same service costs 3.2 times more in Alaska than in New York. 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· 28th of 51
$550
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.