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 $93.33 Median $4,073.80 Typical High $10,000.00 | Facility | None | $93.33 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $239.88 Typical High $309.03 | Professional | None | $69.18 | $239.88 | $309.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $70.79 Median $186.21 Typical High $302.00 | Professional | None | $70.79 | $186.21 | $302.00 |
CareFirst Setting Professional Modifier None Typical Low $69.18 Median $77.62 Typical High $691.83 | Professional | None | $69.18 | $77.62 | $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 $72.44 Median $208.93 Typical High $407.38 | Professional | None | $72.44 | $208.93 | $407.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $63.10 Median $275.42 Typical High $338.84 | Professional | None | $63.10 | $275.42 | $338.84 |
Medcost Setting Facility Modifier None Typical Low $93.33 Median $154.88 Typical High $512.86 | Facility | None | $93.33 | $154.88 | $512.86 |
Medcost Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
Sentara Setting Facility Modifier None Typical Low $79.43 Median $371.54 Typical High $2,454.71 | Facility | None | $79.43 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $275.42 Median $363.08 Typical High $1,174.90 | Professional | None | $275.42 | $363.08 | $1,174.90 |
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 $70.79 Median $190.55 Typical High $489.78 | Professional | None | $70.79 | $190.55 | $489.78 |
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 $34.67 Median $53.70 Typical High $154.88 | Professional | 52 · Reduced service | $34.67 | $53.70 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $21.38 Typical High $63.10 | Professional | 53 · Discontinued | $13.80 | $21.38 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $81.28 Typical High $234.42 | Professional | 54 · Surgery only | $51.29 | $81.28 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $16.22 Typical High $46.77 | Professional | 55 · Aftercare only | $10.47 | $16.22 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $10.72 Typical High $30.90 | Professional | 56 · Pre-op care only | $6.92 | $10.72 | $30.90 |
Where Virginia sits
The same service costs 4.5 times more in Oklahoma than in Nebraska. 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· 37th of 51
$224
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.