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 $36.31 Median $4,073.80 Typical High $10,000.00 | Facility | None | $36.31 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $64.57 Typical High $81.28 | Professional | None | $30.20 | $64.57 | $81.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $28.84 Median $56.23 Typical High $87.10 | Professional | None | $28.84 | $56.23 | $87.10 |
CareFirst Setting Professional Modifier None Typical Low $30.20 Median $33.88 Typical High $39.81 | Professional | None | $30.20 | $33.88 | $39.81 |
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 $28.18 Median $60.26 Typical High $104.71 | Professional | None | $28.18 | $60.26 | $104.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $64.57 Median $85.11 Typical High $102.33 | Professional | None | $64.57 | $85.11 | $102.33 |
Medcost Setting Facility Modifier None Typical Low $36.31 Median $58.88 Typical High $131.83 | Facility | None | $36.31 | $58.88 | $131.83 |
Medcost Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
Sentara Setting Facility Modifier None Typical Low $30.90 Median $309.03 Typical High $2,454.71 | Facility | None | $30.90 | $309.03 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $72.44 Median $93.33 Typical High $1,071.52 | Professional | None | $72.44 | $93.33 | $1,071.52 |
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 $27.54 Median $58.88 Typical High $117.49 | Professional | None | $27.54 | $58.88 | $117.49 |
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 $15.14 Median $28.18 Typical High $39.81 | Professional | 52 · Reduced service | $15.14 | $28.18 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $9.33 Typical High $15.85 | Professional | 53 · Discontinued | $6.03 | $9.33 | $15.85 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $22.91 Median $35.48 Typical High $60.26 | Professional | 54 · Surgery only | $22.91 | $35.48 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $8.51 Typical High $12.02 | Professional | 55 · Aftercare only | $4.57 | $8.51 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $5.62 Typical High $7.94 | Professional | 56 · Pre-op care only | $3.02 | $5.62 | $7.94 |
Where Virginia sits
The same service costs 3.3 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· 40th of 51
$64.57
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.