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 $85.11 Median $2,818.38 Typical High $9,332.54 | Facility | None | $85.11 | $2,818.38 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $134.90 Typical High $208.93 | Professional | None | $56.23 | $134.90 | $208.93 |
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 $123.03 Typical High $190.55 | Professional | None | $53.70 | $123.03 | $190.55 |
CareFirst Setting Professional Modifier None Typical Low $56.23 Median $61.66 Typical High $72.44 | Professional | None | $56.23 | $61.66 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $257.04 Typical High $1,659.59 | Facility | None | $114.82 | $257.04 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $131.83 Typical High $218.78 | Professional | None | $52.48 | $131.83 | $218.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $138.04 Median $181.97 Typical High $218.78 | Professional | None | $138.04 | $181.97 | $218.78 |
Medcost Setting Facility Modifier None Typical Low $67.61 Median $112.20 Typical High $269.15 | Facility | None | $67.61 | $112.20 | $269.15 |
Medcost Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
Sentara Setting Facility Modifier None Typical Low $57.54 Median $371.54 Typical High $2,454.71 | Facility | None | $57.54 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $154.88 Median $194.98 Typical High $1,071.52 | Professional | None | $154.88 | $194.98 | $1,071.52 |
United Setting Facility Modifier None Typical Low $323.59 Median $1,445.44 Typical High $3,630.78 | Facility | None | $323.59 | $1,445.44 | $3,630.78 |
United Setting Professional Modifier None Typical Low $52.48 Median $123.03 Typical High $245.47 | Professional | None | $52.48 | $123.03 | $245.47 |
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 $28.18 Median $43.65 Typical High $83.18 | Professional | 52 · Reduced service | $28.18 | $43.65 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $17.38 Typical High $33.11 | Professional | 53 · Discontinued | $11.22 | $17.38 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $64.57 Typical High $125.89 | Professional | 54 · Surgery only | $41.69 | $64.57 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $12.88 Typical High $25.12 | Professional | 55 · Aftercare only | $8.32 | $12.88 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $8.71 Typical High $16.60 | Professional | 56 · Pre-op care only | $5.62 | $8.71 | $16.60 |
Where Virginia sits
The same service costs 2.6 times more in Alaska than in Montana. 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· 31st of 51
$141
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.