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 $467.74 Median $467.74 Typical High $489.78 | Facility | None | $467.74 | $467.74 | $489.78 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $489.78 Typical High $776.25 | Professional | None | $467.74 | $489.78 | $776.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $467.74 Median $954.99 Typical High $1,513.56 | Facility | None | $467.74 | $954.99 | $1,513.56 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $467.74 Typical High $467.74 | Professional | None | $398.11 | $467.74 | $467.74 |
CareFirst Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $954.99 Typical High $1,202.26 | Facility | None | $676.08 | $954.99 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $398.11 Median $489.78 Typical High $1,071.52 | Professional | None | $398.11 | $489.78 | $1,071.52 |
Medcost Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
Medcost Setting Facility Modifier None Typical Low $467.74 Median $977.24 Typical High $977.24 | Facility | None | $467.74 | $977.24 | $977.24 |
Sentara Setting Facility Modifier None Typical Low $478.63 Median $977.24 Typical High $1,023.29 | Facility | None | $478.63 | $977.24 | $1,023.29 |
Sentara Setting Professional Modifier None Typical Low $478.63 Median $977.24 Typical High $1,023.29 | Professional | None | $478.63 | $977.24 | $1,023.29 |
United Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
United Setting Professional Modifier None Typical Low $467.74 Median $501.19 Typical High $616.60 | Professional | None | $467.74 | $501.19 | $616.60 |
2 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 55 · Aftercare only Typical Low $69.18 Median $70.79 Typical High $74.13 | Professional | 55 · Aftercare only | $69.18 | $70.79 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $48.98 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $48.98 |
Where Virginia sits
The same service costs 3.9 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· 30th of 51
$490
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.