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 $3,235.94 Median $8,317.64 Typical High $20,417.38 | Facility | None | $3,235.94 | $8,317.64 | $20,417.38 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $8,128.31 | Professional | None | $39.81 | $39.81 | $8,128.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,964.78 Median $13,803.84 Typical High $15,848.93 | Facility | None | $10,964.78 | $13,803.84 | $15,848.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $407.38 Median $478.63 Typical High $588.84 | Professional | None | $407.38 | $478.63 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $794.33 Typical High $5,495.41 | Facility | None | $501.19 | $794.33 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | None | $14.45 | $14.45 | $14.45 |
Medcost Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $60.26 | Facility | None | $39.81 | $39.81 | $60.26 |
Sentara Setting Facility Modifier None Typical Low $1,023.29 Median $2,187.76 Typical High $10,232.93 | Facility | None | $1,023.29 | $2,187.76 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1,288.25 Median $4,570.88 Typical High $11,481.54 | Professional | None | $1,288.25 | $4,570.88 | $11,481.54 |
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 |
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 $19.95 Median $19.95 Typical High $19.95 | Professional | 52 · Reduced service | $19.95 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | 53 · Discontinued | $7.94 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | 54 · Surgery only | $30.20 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | 55 · Aftercare only | $6.03 | $6.03 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | 56 · Pre-op care only | $3.98 | $3.98 | $3.98 |
Where Virginia sits
The same service costs 295.1 times more in Alaska than in West Virginia. 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· 39th of 51
$513
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.