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 $3,890.45 Median $3,890.45 Typical High $4,168.69 | Facility | None | $3,890.45 | $3,890.45 | $4,168.69 |
Aetna Setting Professional Modifier None Typical Low $3,890.45 Median $3,981.07 Typical High $4,168.69 | Professional | None | $3,890.45 | $3,981.07 | $4,168.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,801.89 Median $7,943.28 Typical High $12,882.50 | Facility | None | $3,801.89 | $7,943.28 | $12,882.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,311.31 Median $3,890.45 Typical High $3,890.45 | Professional | None | $3,311.31 | $3,890.45 | $3,890.45 |
CareFirst Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,801.89 | Professional | None | $3,467.37 | $3,467.37 | $3,801.89 |
Cigna Setting Facility Modifier None Typical Low $5,754.40 Median $7,413.10 Typical High $10,232.93 | Facility | None | $5,754.40 | $7,413.10 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Professional | None | $3,890.45 | $3,890.45 | $3,890.45 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,311.31 Median $4,168.69 Typical High $4,897.79 | Professional | None | $3,311.31 | $4,168.69 | $4,897.79 |
Medcost Setting Facility Modifier None Typical Low $4,168.69 Median $4,168.69 Typical High $4,466.84 | Facility | None | $4,168.69 | $4,168.69 | $4,466.84 |
Sentara Setting Facility Modifier None Typical Low $3,801.89 Median $4,073.80 Typical High $5,128.61 | Facility | None | $3,801.89 | $4,073.80 | $5,128.61 |
Sentara Setting Professional Modifier None Typical Low $3,801.89 Median $4,073.80 Typical High $5,128.61 | Professional | None | $3,801.89 | $4,073.80 | $5,128.61 |
United Setting Facility Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Facility | None | $3,890.45 | $3,890.45 | $3,890.45 |
United Setting Professional Modifier None Typical Low $3,715.35 Median $3,801.89 Typical High $3,981.07 | Professional | None | $3,715.35 | $3,801.89 | $3,981.07 |
4 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 $1,949.84 Median $1,995.26 Typical High $2,041.74 | Professional | 52 · Reduced service | $1,949.84 | $1,995.26 | $2,041.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $794.33 Median $794.33 Typical High $831.76 | Professional | 53 · Discontinued | $794.33 | $794.33 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $588.84 Median $588.84 Typical High $616.60 | Professional | 55 · Aftercare only | $588.84 | $588.84 | $616.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $389.05 Median $398.11 Typical High $416.87 | Professional | 56 · Pre-op care only | $389.05 | $398.11 | $416.87 |
Where Virginia sits
The same service costs 11.0 times more in Alabama than in Oklahoma. 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
$3,890
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.