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 $128.82 Median $4,073.80 Typical High $10,000.00 | Facility | None | $128.82 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $204.17 Typical High $275.42 | Professional | None | $109.65 | $204.17 | $275.42 |
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 $109.65 Median $186.21 Typical High $281.84 | Professional | None | $109.65 | $186.21 | $281.84 |
CareFirst Setting Professional Modifier None Typical Low $87.10 Median $97.72 Typical High $97.72 | Professional | None | $87.10 | $97.72 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $354.81 Typical High $478.63 | Facility | None | $281.84 | $354.81 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $186.21 Typical High $346.74 | Professional | None | $89.13 | $186.21 | $346.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $162.18 Median $213.80 Typical High $251.19 | Professional | None | $162.18 | $213.80 | $251.19 |
Medcost Setting Professional Modifier None Typical Low $288.40 Median $562.34 Typical High $562.34 | Professional | None | $288.40 | $562.34 | $562.34 |
Medcost Setting Facility Modifier None Typical Low $128.82 Median $218.78 Typical High $446.68 | Facility | None | $128.82 | $218.78 | $446.68 |
Medcost Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
Sentara Setting Facility Modifier None Typical Low $93.33 Median $190.55 Typical High $10,232.93 | Facility | None | $93.33 | $190.55 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $169.82 Median $281.84 Typical High $588.84 | Professional | None | $169.82 | $281.84 | $588.84 |
United Setting Facility Modifier None Typical Low $776.25 Median $851.14 Typical High $1,905.46 | Facility | None | $776.25 | $851.14 | $1,905.46 |
United Setting Professional Modifier None Typical Low $100.00 Median $190.55 Typical High $346.74 | Professional | None | $100.00 | $190.55 | $346.74 |
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 $54.95 Median $72.44 Typical High $128.82 | Professional | 52 · Reduced service | $54.95 | $72.44 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $33.88 Typical High $51.29 | Professional | 53 · Discontinued | $21.88 | $33.88 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $107.15 Typical High $194.98 | Professional | 54 · Surgery only | $81.28 | $107.15 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $25.70 Typical High $38.90 | Professional | 55 · Aftercare only | $16.22 | $25.70 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $14.45 Typical High $25.70 | Professional | 56 · Pre-op care only | $10.96 | $14.45 | $25.70 |
Where Virginia sits
The same service costs 3.4 times more in Alaska than in Maryland. 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· 42nd of 51
$191
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.