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 $77.62 Median $234.42 Typical High $8,317.64 | Facility | None | $77.62 | $234.42 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $104.71 Typical High $223.87 | Professional | None | $53.70 | $104.71 | $223.87 |
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 $53.70 Median $91.20 Typical High $131.83 | Professional | None | $53.70 | $91.20 | $131.83 |
CareFirst Setting Professional Modifier None Typical Low $51.29 Median $57.54 Typical High $691.83 | Professional | None | $51.29 | $57.54 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $70.79 Typical High $123.03 | Facility | None | $50.12 | $70.79 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $100.00 Typical High $173.78 | Professional | None | $54.95 | $100.00 | $173.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $44.67 Median $117.49 Typical High $144.54 | Professional | None | $44.67 | $117.49 | $144.54 |
Medcost Setting Professional Modifier None Typical Low $181.97 Median $229.09 Typical High $229.09 | Professional | None | $181.97 | $229.09 | $229.09 |
Medcost Setting Facility Modifier None Typical Low $63.10 Median $102.33 Typical High $181.97 | Facility | None | $63.10 | $102.33 | $181.97 |
Medcost Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
Sentara Setting Facility Modifier None Typical Low $46.77 Median $257.04 Typical High $2,454.71 | Facility | None | $46.77 | $257.04 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $97.72 Median $158.49 Typical High $870.96 | Professional | None | $97.72 | $158.49 | $870.96 |
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 $51.29 Median $102.33 Typical High $194.98 | Professional | None | $51.29 | $102.33 | $194.98 |
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 $26.92 Median $38.90 Typical High $54.95 | Professional | 52 · Reduced service | $26.92 | $38.90 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $15.85 Typical High $21.88 | Professional | 53 · Discontinued | $10.96 | $15.85 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $58.88 Typical High $81.28 | Professional | 54 · Surgery only | $40.74 | $58.88 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $12.02 Typical High $16.22 | Professional | 55 · Aftercare only | $8.13 | $12.02 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $8.13 Typical High $10.96 | Professional | 56 · Pre-op care only | $5.37 | $8.13 | $10.96 |
Where Virginia sits
The same service costs 2.8 times more in Alaska than in Pennsylvania. 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· 42nd of 51
$102
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.