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 $389.05 Median $389.05 Typical High $407.38 | Facility | None | $389.05 | $389.05 | $407.38 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $407.38 Typical High $588.84 | Professional | None | $239.88 | $407.38 | $588.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $794.33 Typical High $1,258.93 | Facility | None | $389.05 | $794.33 | $1,258.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
CareFirst Setting Professional Modifier None Typical Low $371.54 Median $389.05 Typical High $389.05 | Professional | None | $371.54 | $389.05 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $794.33 Typical High $1,000.00 | Facility | None | $562.34 | $794.33 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
Kaiser Permanente Setting Professional Modifier None Typical Low $295.12 Median $389.05 Typical High $467.74 | Professional | None | $295.12 | $389.05 | $467.74 |
Medcost Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
Medcost Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $707.95 | Facility | None | $389.05 | $389.05 | $707.95 |
Medcost Setting Professional Modifier None Typical Low $91.20 Median $389.05 Typical High $407.38 | Professional | None | $91.20 | $389.05 | $407.38 |
Sentara Setting Facility Modifier None Typical Low $389.05 Median $436.52 Typical High $512.86 | Facility | None | $389.05 | $436.52 | $512.86 |
Sentara Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $457.09 | Professional | None | $389.05 | $389.05 | $457.09 |
United Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
United Setting Professional Modifier None Typical Low $239.88 Median $389.05 Typical High $407.38 | Professional | None | $239.88 | $389.05 | $407.38 |
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 $194.98 Median $204.17 Typical High $204.17 | Professional | 52 · Reduced service | $194.98 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $81.28 Typical High $81.28 | Professional | 53 · Discontinued | $77.62 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $61.66 Typical High $61.66 | Professional | 55 · Aftercare only | $58.88 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $40.74 Typical High $40.74 | Professional | 56 · Pre-op care only | $38.90 | $40.74 | $40.74 |
Where Virginia sits
The same service costs 1.7 times more in Alaska 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· 45th of 51
$389
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.