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 $32.36 Median $4,073.80 Typical High $10,000.00 | Facility | None | $32.36 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $26.30 Median $51.29 Typical High $74.13 | Professional | None | $26.30 | $51.29 | $74.13 |
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 $25.70 Median $41.69 Typical High $72.44 | Professional | None | $25.70 | $41.69 | $72.44 |
CareFirst Setting Professional Modifier None Typical Low $25.12 Median $28.18 Typical High $33.11 | Professional | None | $25.12 | $28.18 | $33.11 |
Cigna Setting Facility Modifier None Typical Low $38.02 Median $50.12 Typical High $75.86 | Facility | None | $38.02 | $50.12 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $50.12 Typical High $74.13 | Professional | None | $24.55 | $50.12 | $74.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $53.70 Median $70.79 Typical High $83.18 | Professional | None | $53.70 | $70.79 | $83.18 |
Medcost Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $77.62 | Professional | None | $64.57 | $64.57 | $77.62 |
Medcost Setting Facility Modifier None Typical Low $32.36 Median $52.48 Typical High $100.00 | Facility | None | $32.36 | $52.48 | $100.00 |
Medcost Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
Sentara Setting Facility Modifier None Typical Low $26.30 Median $371.54 Typical High $2,454.71 | Facility | None | $26.30 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $40.74 Median $66.07 Typical High $1,071.52 | Professional | None | $40.74 | $66.07 | $1,071.52 |
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 $25.12 Median $45.71 Typical High $85.11 | Professional | None | $25.12 | $45.71 | $85.11 |
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 $13.18 Median $21.38 Typical High $30.90 | Professional | 52 · Reduced service | $13.18 | $21.38 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $8.71 Typical High $12.30 | Professional | 53 · Discontinued | $5.25 | $8.71 | $12.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.50 Median $31.62 Typical High $45.71 | Professional | 54 · Surgery only | $19.50 | $31.62 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $6.46 Typical High $9.33 | Professional | 55 · Aftercare only | $3.89 | $6.46 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $4.47 Typical High $6.17 | Professional | 56 · Pre-op care only | $2.63 | $4.47 | $6.17 |
Where Virginia sits
The same service costs 3.3 times more in Alaska than in New Jersey. 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· 32nd of 51
$53.70
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.