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 $33.11 Median $4,073.80 Typical High $10,000.00 | Facility | None | $33.11 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $27.54 Median $70.79 Typical High $112.20 | Professional | None | $27.54 | $70.79 | $112.20 |
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 $26.92 Median $72.44 Typical High $109.65 | Professional | None | $26.92 | $72.44 | $109.65 |
CareFirst Setting Professional Modifier None Typical Low $21.38 Median $23.99 Typical High $28.18 | Professional | None | $21.38 | $23.99 | $28.18 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $74.13 Typical High $128.82 | Facility | None | $50.12 | $74.13 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $69.18 Typical High $102.33 | Professional | None | $25.70 | $69.18 | $102.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $81.28 Median $107.15 Typical High $128.82 | Professional | None | $81.28 | $107.15 | $128.82 |
Medcost Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $102.33 | Professional | None | $81.28 | $81.28 | $102.33 |
Medcost Setting Facility Modifier None Typical Low $33.11 Median $57.54 Typical High $134.90 | Facility | None | $33.11 | $57.54 | $134.90 |
Medcost Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
Sentara Setting Facility Modifier None Typical Low $30.90 Median $371.54 Typical High $2,454.71 | Facility | None | $30.90 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $43.65 Median $87.10 Typical High $1,071.52 | Professional | None | $43.65 | $87.10 | $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 $26.92 Median $58.88 Typical High $107.15 | Professional | None | $26.92 | $58.88 | $107.15 |
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 $13.80 Median $22.39 Typical High $46.77 | Professional | 52 · Reduced service | $13.80 | $22.39 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.50 Median $10.47 Typical High $19.05 | Professional | 53 · Discontinued | $5.50 | $10.47 | $19.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $20.42 Median $38.90 Typical High $70.79 | Professional | 54 · Surgery only | $20.42 | $38.90 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $7.76 Typical High $14.13 | Professional | 55 · Aftercare only | $4.07 | $7.76 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $5.50 Typical High $9.33 | Professional | 56 · Pre-op care only | $2.75 | $5.50 | $9.33 |
Where Virginia sits
The same service costs 3.5 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· 33rd of 51
$74.13
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.