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 $2,089.30 Median $2,089.30 Typical High $3,311.31 | Facility | None | $2,089.30 | $2,089.30 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $2,089.30 Typical High $3,981.07 | Professional | None | $1,819.70 | $2,089.30 | $3,981.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $870.96 Typical High $1,174.90 | Professional | None | $741.31 | $870.96 | $1,174.90 |
CareFirst Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Professional | None | $2,344.23 | $2,344.23 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $7,585.78 | Facility | None | $7,585.78 | $7,585.78 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,290.87 | $2,290.87 | $2,290.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,951.21 Median $3,801.89 Typical High $4,265.80 | Professional | None | $2,951.21 | $3,801.89 | $4,265.80 |
Medcost Setting Facility Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Facility | None | $3,235.94 | $3,235.94 | $3,235.94 |
Medcost Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,995.26 | Professional | None | $1,737.80 | $1,737.80 | $1,995.26 |
Sentara Setting Facility Modifier None Typical Low $2,089.30 Median $4,570.88 Typical High $10,964.78 | Facility | None | $2,089.30 | $4,570.88 | $10,964.78 |
Sentara Setting Professional Modifier None Typical Low $2,344.23 Median $3,467.37 Typical High $10,232.93 | Professional | None | $2,344.23 | $3,467.37 | $10,232.93 |
United Setting Facility Modifier None Typical Low $5,754.40 Median $9,772.37 Typical High $19,952.62 | Facility | None | $5,754.40 | $9,772.37 | $19,952.62 |
United Setting Professional Modifier None Typical Low $263.03 Median $2,691.53 Typical High $4,073.80 | Professional | None | $263.03 | $2,691.53 | $4,073.80 |
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 $891.25 Median $1,047.13 Typical High $1,659.59 | Professional | 52 · Reduced service | $891.25 | $1,047.13 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $416.87 Typical High $660.69 | Professional | 53 · Discontinued | $354.81 | $416.87 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,584.89 Typical High $2,454.71 | Professional | 54 · Surgery only | $1,348.96 | $1,584.89 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $316.23 Typical High $489.78 | Professional | 55 · Aftercare only | $269.15 | $316.23 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $208.93 Typical High $331.13 | Professional | 56 · Pre-op care only | $177.83 | $208.93 | $331.13 |
Where Virginia sits
The same service costs 9.3 times more in Alaska than in Indiana. 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· 48th of 51
$1,148
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.