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 $107.15 Median $4,073.80 Typical High $10,000.00 | Facility | None | $107.15 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $107.15 Typical High $398.11 | Professional | None | $66.07 | $107.15 | $398.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $2,398.83 Typical High $2,951.21 | Facility | None | $1,698.24 | $2,398.83 | $2,951.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $58.88 Median $70.79 Typical High $87.10 | Professional | None | $58.88 | $70.79 | $87.10 |
CareFirst Setting Professional Modifier None Typical Low $64.57 Median $72.44 Typical High $72.44 | Professional | None | $64.57 | $72.44 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $91.20 Typical High $1,621.81 | Facility | None | $51.29 | $91.20 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $91.20 Median $120.23 Typical High $141.25 | Professional | None | $91.20 | $120.23 | $141.25 |
Medcost Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $602.56 | Facility | None | $398.11 | $398.11 | $602.56 |
Medcost Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
Sentara Setting Facility Modifier None Typical Low $89.13 Median $891.25 Typical High $10,232.93 | Facility | None | $89.13 | $891.25 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $102.33 Median $162.18 Typical High $10,232.93 | Professional | None | $102.33 | $162.18 | $10,232.93 |
United Setting Facility Modifier None Typical Low $100.00 Median $660.69 Typical High $2,041.74 | Facility | None | $100.00 | $660.69 | $2,041.74 |
United Setting Professional Modifier None Typical Low $58.88 Median $100.00 Typical High $173.78 | Professional | None | $58.88 | $100.00 | $173.78 |
5 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 $32.36 Median $50.12 Typical High $199.53 | Professional | 52 · Reduced service | $32.36 | $50.12 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $19.95 Typical High $79.43 | Professional | 53 · Discontinued | $12.88 | $19.95 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $75.86 Typical High $302.00 | Professional | 54 · Surgery only | $48.98 | $75.86 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $14.79 Typical High $60.26 | Professional | 55 · Aftercare only | $9.77 | $14.79 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $10.00 Typical High $39.81 | Professional | 56 · Pre-op care only | $6.46 | $10.00 | $39.81 |
Where Virginia sits
The same service costs 3.4 times more in Alaska than in Virginia. 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· 51st of 51
$77.62
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.