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 $416.87 Median $5,495.41 Typical High $14,125.38 | Facility | None | $416.87 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $416.87 Typical High $416.87 | Professional | None | $363.08 | $416.87 | $416.87 |
CareFirst Setting Professional Modifier None Typical Low $354.81 Median $6,456.54 Typical High $8,317.64 | Professional | None | $354.81 | $6,456.54 | $8,317.64 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $3,548.13 Typical High $7,079.46 | Facility | None | $512.86 | $3,548.13 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $346.74 Median $416.87 Typical High $512.86 | Professional | None | $346.74 | $416.87 | $512.86 |
Medcost Setting Facility Modifier None Typical Low $416.87 Median $537.03 Typical High $676.08 | Facility | None | $416.87 | $537.03 | $676.08 |
Medcost Setting Professional Modifier None Typical Low $281.84 Median $316.23 Typical High $389.05 | Professional | None | $281.84 | $316.23 | $389.05 |
Sentara Setting Facility Modifier None Typical Low $389.05 Median $1,698.24 Typical High $11,481.54 | Facility | None | $389.05 | $1,698.24 | $11,481.54 |
Sentara Setting Professional Modifier None Typical Low $389.05 Median $467.74 Typical High $891.25 | Professional | None | $389.05 | $467.74 | $891.25 |
United Setting Facility Modifier None Typical Low $2,570.40 Median $10,000.00 Typical High $25,118.86 | Facility | None | $2,570.40 | $10,000.00 | $25,118.86 |
United Setting Professional Modifier None Typical Low $263.03 Median $354.81 Typical High $660.69 | Professional | None | $263.03 | $354.81 | $660.69 |
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 $177.83 Median $208.93 Typical High $208.93 | Professional | 52 · Reduced service | $177.83 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $83.18 Typical High $83.18 | Professional | 53 · Discontinued | $70.79 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $316.23 Typical High $316.23 | Professional | 54 · Surgery only | $269.15 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $63.10 Typical High $63.10 | Professional | 55 · Aftercare only | $53.70 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $41.69 Typical High $41.69 | Professional | 56 · Pre-op care only | $35.48 | $41.69 | $41.69 |
Where Virginia sits
The same service costs 4.5 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· 33rd of 51
$417
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.