How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $8,912.51 Median $8,912.51 Typical High $8,912.51 | Facility | None | $8,912.51 | $8,912.51 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $8,912.51 Median $8,912.51 Typical High $8,912.51 | Professional | None | $8,912.51 | $8,912.51 | $8,912.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $8,511.38 Median $8,511.38 Typical High $8,511.38 | Professional | None | $8,511.38 | $8,511.38 | $8,511.38 |
CareFirst Setting Professional Modifier None Typical Low $8,511.38 Median $8,511.38 Typical High $8,511.38 | Professional | None | $8,511.38 | $8,511.38 | $8,511.38 |
Cigna Setting Facility Modifier None Typical Low $9,332.54 Median $18,197.01 Typical High $22,387.21 | Facility | None | $9,332.54 | $18,197.01 | $22,387.21 |
Cigna Setting Professional Modifier None Typical Low $8,912.51 Median $8,912.51 Typical High $8,912.51 | Professional | None | $8,912.51 | $8,912.51 | $8,912.51 |
Kaiser Permanente Setting Professional Modifier None Typical Low $295.12 Median $549.54 Typical High $10,471.29 | Professional | None | $295.12 | $549.54 | $10,471.29 |
Medcost Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
Medcost Setting Facility Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $13,803.84 | Facility | None | $9,120.11 | $9,120.11 | $13,803.84 |
Medcost Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $8,709.64 | Professional | None | $144.54 | $144.54 | $8,709.64 |
Sentara Setting Facility Modifier None Typical Low $8,511.38 Median $9,332.54 Typical High $11,481.54 | Facility | None | $8,511.38 | $9,332.54 | $11,481.54 |
Sentara Setting Professional Modifier None Typical Low $8,709.64 Median $8,709.64 Typical High $9,549.93 | Professional | None | $8,709.64 | $8,709.64 | $9,549.93 |
United Setting Professional Modifier None Typical Low $8,709.64 Median $9,332.54 Typical High $9,772.37 | Professional | None | $8,709.64 | $9,332.54 | $9,772.37 |
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 $4,466.84 Median $4,466.84 Typical High $4,466.84 | Professional | 52 · Reduced service | $4,466.84 | $4,466.84 | $4,466.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | 53 · Discontinued | $1,778.28 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | 55 · Aftercare only | $1,348.96 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | 56 · Pre-op care only | $891.25 | $891.25 | $891.25 |
Where Virginia sits
The same service costs 26.3 times more in Alaska than in Montana. 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· 10th of 51
$8,913
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.