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 $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $537.03 Typical High $660.69 | Professional | None | $457.09 | $537.03 | $660.69 |
CareFirst Setting Professional Modifier None Typical Low $512.86 Median $575.44 Typical High $660.69 | Professional | None | $512.86 | $575.44 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,258.93 | Facility | None | $1,096.48 | $1,096.48 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $501.19 Typical High $676.08 | Professional | None | $446.68 | $501.19 | $676.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $512.86 Median $562.34 Typical High $758.58 | Professional | None | $512.86 | $562.34 | $758.58 |
Medcost Setting Professional Modifier None Typical Low $524.81 Median $645.65 Typical High $645.65 | Professional | None | $524.81 | $645.65 | $645.65 |
Medcost Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $794.33 | Facility | None | $616.60 | $616.60 | $794.33 |
Medcost Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $501.19 | Professional | None | $338.84 | $338.84 | $501.19 |
Sentara Setting Facility Modifier None Typical Low $380.19 Median $630.96 Typical High $10,232.93 | Facility | None | $380.19 | $630.96 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $446.68 Median $489.78 Typical High $741.31 | Professional | None | $446.68 | $489.78 | $741.31 |
United Setting Professional Modifier None Typical Low $323.59 Median $416.87 Typical High $691.83 | Professional | None | $323.59 | $416.87 | $691.83 |
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 $229.09 Median $234.42 Typical High $234.42 | Professional | 52 · Reduced service | $229.09 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | 53 · Discontinued | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $46.77 |
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· 29th of 51
$525
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.