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 $213.80 Median $5,495.41 Typical High $14,125.38 | Facility | None | $213.80 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $213.80 Typical High $323.59 | Professional | None | $173.78 | $213.80 | $323.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $173.78 Median $204.17 Typical High $257.04 | Professional | None | $173.78 | $204.17 | $257.04 |
CareFirst Setting Professional Modifier None Typical Low $181.97 Median $204.17 Typical High $251.19 | Professional | None | $181.97 | $204.17 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $501.19 Typical High $50,118.72 | Facility | None | $100.00 | $501.19 | $50,118.72 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $234.42 Typical High $389.05 | Professional | None | $177.83 | $234.42 | $389.05 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $186.21 Typical High $229.09 | Professional | None | $154.88 | $186.21 | $229.09 |
Medcost Setting Professional Modifier None Typical Low $208.93 Median $263.03 Typical High $263.03 | Professional | None | $208.93 | $263.03 | $263.03 |
Medcost Setting Facility Modifier None Typical Low $213.80 Median $263.03 Typical High $354.81 | Facility | None | $213.80 | $263.03 | $354.81 |
Medcost Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
Sentara Setting Facility Modifier None Typical Low $173.78 Median $933.25 Typical High $4,570.88 | Facility | None | $173.78 | $933.25 | $4,570.88 |
Sentara Setting Professional Modifier None Typical Low $181.97 Median $269.15 Typical High $2,187.76 | Professional | None | $181.97 | $269.15 | $2,187.76 |
United Setting Facility Modifier None Typical Low $436.52 Median $2,344.23 Typical High $6,309.57 | Facility | None | $436.52 | $2,344.23 | $6,309.57 |
United Setting Professional Modifier None Typical Low $165.96 Median $251.19 Typical High $398.11 | Professional | None | $165.96 | $251.19 | $398.11 |
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 $87.10 Median $107.15 Typical High $107.15 | Professional | 52 · Reduced service | $87.10 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $42.66 Typical High $42.66 | Professional | 53 · Discontinued | $34.67 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $162.18 Typical High $162.18 | Professional | 54 · Surgery only | $131.83 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $32.36 Typical High $32.36 | Professional | 55 · Aftercare only | $26.30 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $21.38 Typical High $21.38 | Professional | 56 · Pre-op care only | $17.38 | $21.38 | $21.38 |
Where Virginia sits
The same service costs 3.8 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· 44th of 51
$224
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.