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 $5,011.87 Median $5,011.87 Typical High $5,011.87 | Facility | None | $5,011.87 | $5,011.87 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,011.87 | Professional | None | $5,011.87 | $5,011.87 | $5,011.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,128.61 Median $11,220.18 Typical High $17,378.01 | Facility | None | $5,128.61 | $11,220.18 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,011.87 | Professional | None | $5,011.87 | $5,011.87 | $5,011.87 |
CareFirst Setting Professional Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $5,128.61 | Professional | None | $5,128.61 | $5,128.61 | $5,128.61 |
Cigna Setting Facility Modifier None Typical Low $5,248.07 Median $10,000.00 Typical High $12,589.25 | Facility | None | $5,248.07 | $10,000.00 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,011.87 | Professional | None | $5,011.87 | $5,011.87 | $5,011.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4,677.35 Median $5,495.41 Typical High $6,918.31 | Professional | None | $4,677.35 | $5,495.41 | $6,918.31 |
Medcost Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $3,548.13 | Professional | None | $2,511.89 | $2,511.89 | $3,548.13 |
Medcost Setting Facility Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $7,413.10 | Facility | None | $5,128.61 | $5,128.61 | $7,413.10 |
Medcost Setting Professional Modifier None Typical Low $1,479.11 Median $2,754.23 Typical High $5,888.44 | Professional | None | $1,479.11 | $2,754.23 | $5,888.44 |
United Setting Professional Modifier None Typical Low $4,897.79 Median $5,128.61 Typical High $5,495.41 | Professional | None | $4,897.79 | $5,128.61 | $5,495.41 |
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 $2,511.89 Median $2,511.89 Typical High $2,511.89 | Professional | 52 · Reduced service | $2,511.89 | $2,511.89 | $2,511.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | 53 · Discontinued | $1,000.00 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | 55 · Aftercare only | $741.31 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | 56 · Pre-op care only | $501.19 | $501.19 | $501.19 |
Where Virginia sits
The same service costs 1.8 times more in Alaska than in North Carolina. 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· 22nd of 51
$5,012
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.