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 $56.23 Median $1,348.96 Typical High $8,317.64 | Facility | None | $56.23 | $1,348.96 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $60.26 Typical High $104.71 | Professional | None | $48.98 | $60.26 | $104.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $47.86 Median $60.26 Typical High $79.43 | Professional | None | $47.86 | $60.26 | $79.43 |
CareFirst Setting Professional Modifier None Typical Low $46.77 Median $51.29 Typical High $691.83 | Professional | None | $46.77 | $51.29 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,230.27 Typical High $3,019.95 | Facility | None | $512.86 | $1,230.27 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $64.57 Typical High $104.71 | Professional | None | $50.12 | $64.57 | $104.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $41.69 Median $69.18 Typical High $87.10 | Professional | None | $41.69 | $69.18 | $87.10 |
Medcost Setting Facility Modifier None Typical Low $56.23 Median $67.61 Typical High $109.65 | Facility | None | $56.23 | $67.61 | $109.65 |
Medcost Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Sentara Setting Facility Modifier None Typical Low $50.12 Median $302.00 Typical High $2,454.71 | Facility | None | $50.12 | $302.00 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $61.66 Median $79.43 Typical High $870.96 | Professional | None | $61.66 | $79.43 | $870.96 |
United Setting Facility Modifier None Typical Low $100.00 Median $660.69 Typical High $2,089.30 | Facility | None | $100.00 | $660.69 | $2,089.30 |
United Setting Professional Modifier None Typical Low $42.66 Median $72.44 Typical High $109.65 | Professional | None | $42.66 | $72.44 | $109.65 |
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 $24.55 Median $28.18 Typical High $33.88 | Professional | 52 · Reduced service | $24.55 | $28.18 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $11.22 Typical High $13.49 | Professional | 53 · Discontinued | $9.77 | $11.22 | $13.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $41.69 Typical High $50.12 | Professional | 54 · Surgery only | $36.31 | $41.69 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $8.51 Typical High $10.00 | Professional | 55 · Aftercare only | $7.41 | $8.51 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $5.62 Typical High $6.76 | Professional | 56 · Pre-op care only | $4.90 | $5.62 | $6.76 |
Where Virginia sits
The same service costs 4.8 times more in Alaska than in Kentucky. 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· 39th of 51
$64.57
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.