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 $1,659.59 Median $1,659.59 Typical High $1,737.80 | Facility | None | $1,659.59 | $1,659.59 | $1,737.80 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,659.59 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $812.83 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $812.83 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $331.13 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $245.47 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $165.96 | $173.78 | $173.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
CareFirst Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,659.59 | $1,659.59 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $223.87 Typical High $331.13 | Facility | None | $138.04 | $223.87 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $125.89 Median $158.49 Typical High $1,348.96 | Professional | None | $125.89 | $158.49 | $1,348.96 |
Medcost Setting Facility Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $2,630.27 | Facility | None | $1,548.82 | $1,548.82 | $2,630.27 |
Medcost Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $1,548.82 | Professional | None | $109.65 | $109.65 | $1,548.82 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $134.90 | Professional | None | $125.89 | $125.89 | $134.90 |
1 more rate 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 54 · Surgery only Typical Low $1,230.27 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,230.27 | $1,288.25 | $1,288.25 |
Where Virginia sits
The same service costs 15.1 times more in Arkansas 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· 21st of 51
$1,259
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.