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 $23.99 Median $3,801.89 Typical High $9,332.54 | Facility | None | $23.99 | $3,801.89 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $12.88 Median $30.20 Typical High $47.86 | Professional | None | $12.88 | $30.20 | $47.86 |
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 $13.18 Median $27.54 Typical High $42.66 | Professional | None | $13.18 | $27.54 | $42.66 |
CareFirst Setting Professional Modifier None Typical Low $11.22 Median $12.30 Typical High $14.45 | Professional | None | $11.22 | $12.30 | $14.45 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $1,230.27 | Facility | None | $50.12 | $50.12 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $13.18 Median $28.18 Typical High $41.69 | Professional | None | $13.18 | $28.18 | $41.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $29.51 Median $38.90 Typical High $46.77 | Professional | None | $29.51 | $38.90 | $46.77 |
Medcost Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $43.65 | Professional | None | $35.48 | $35.48 | $43.65 |
Medcost Setting Facility Modifier None Typical Low $13.49 Median $26.92 Typical High $60.26 | Facility | None | $13.49 | $26.92 | $60.26 |
Medcost Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | None | $57.54 | $57.54 | $57.54 |
Sentara Setting Facility Modifier None Typical Low $14.13 Median $165.96 Typical High $2,454.71 | Facility | None | $14.13 | $165.96 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $23.44 Median $38.02 Typical High $1,071.52 | Professional | None | $23.44 | $38.02 | $1,071.52 |
United Setting Facility Modifier None Typical Low $100.00 Median $645.65 Typical High $2,041.74 | Facility | None | $100.00 | $645.65 | $2,041.74 |
United Setting Professional Modifier None Typical Low $13.18 Median $25.70 Typical High $50.12 | Professional | None | $13.18 | $25.70 | $50.12 |
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 $6.46 Median $11.75 Typical High $15.49 | Professional | 52 · Reduced service | $6.46 | $11.75 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.57 Median $4.79 Typical High $6.31 | Professional | 53 · Discontinued | $2.57 | $4.79 | $6.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $9.77 Median $17.78 Typical High $23.44 | Professional | 54 · Surgery only | $9.77 | $17.78 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.95 Median $3.55 Typical High $4.68 | Professional | 55 · Aftercare only | $1.95 | $3.55 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.29 Median $2.40 Typical High $3.16 | Professional | 56 · Pre-op care only | $1.29 | $2.40 | $3.16 |
Where Virginia sits
The same service costs 3.5 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· 33rd of 51
$30.20
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.