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 $74.13 Median $4,365.16 Typical High $14,125.38 | Facility | None | $74.13 | $4,365.16 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $109.65 Typical High $181.97 | Professional | None | $61.66 | $109.65 | $181.97 |
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 $58.88 Median $109.65 Typical High $165.96 | Professional | None | $58.88 | $109.65 | $165.96 |
CareFirst Setting Professional Modifier None Typical Low $61.66 Median $69.18 Typical High $81.28 | Professional | None | $61.66 | $69.18 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $97.72 Typical High $181.97 | Facility | None | $50.12 | $97.72 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $112.20 Typical High $162.18 | Professional | None | $58.88 | $112.20 | $162.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $120.23 Median $158.49 Typical High $190.55 | Professional | None | $120.23 | $158.49 | $190.55 |
Medcost Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $141.25 | Professional | None | $123.03 | $123.03 | $141.25 |
Medcost Setting Facility Modifier None Typical Low $74.13 Median $120.23 Typical High $245.47 | Facility | None | $74.13 | $120.23 | $245.47 |
Medcost Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
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 $85.11 Median $141.25 Typical High $1,071.52 | Professional | None | $85.11 | $141.25 | $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 $53.70 Median $102.33 Typical High $181.97 | Professional | None | $53.70 | $102.33 | $181.97 |
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 $30.90 Median $43.65 Typical High $75.86 | Professional | 52 · Reduced service | $30.90 | $43.65 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $17.78 Typical High $30.20 | Professional | 53 · Discontinued | $12.30 | $17.78 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $66.07 Typical High $112.20 | Professional | 54 · Surgery only | $46.77 | $66.07 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $13.18 Typical High $22.91 | Professional | 55 · Aftercare only | $9.33 | $13.18 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $8.91 Typical High $15.14 | Professional | 56 · Pre-op care only | $6.17 | $8.91 | $15.14 |
Where Virginia sits
The same service costs 3.2 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· 27th of 51
$115
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.