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 $109.65 Median $4,365.16 Typical High $14,125.38 | Facility | None | $109.65 | $4,365.16 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $123.03 Typical High $147.91 | Professional | None | $102.33 | $123.03 | $147.91 |
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 $97.72 Median $134.90 Typical High $186.21 | Professional | None | $97.72 | $134.90 | $186.21 |
CareFirst Setting Professional Modifier None Typical Low $93.33 Median $104.71 Typical High $123.03 | Professional | None | $93.33 | $104.71 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $95.50 Typical High $177.83 | Facility | None | $50.12 | $95.50 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $141.25 Typical High $194.98 | Professional | None | $95.50 | $141.25 | $194.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $141.25 Median $186.21 Typical High $223.87 | Professional | None | $141.25 | $186.21 | $223.87 |
Medcost Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $229.09 | Professional | None | $194.98 | $194.98 | $229.09 |
Medcost Setting Facility Modifier None Typical Low $109.65 Median $147.91 Typical High $239.88 | Facility | None | $109.65 | $147.91 | $239.88 |
Medcost Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
Sentara Setting Facility Modifier None Typical Low $87.10 Median $371.54 Typical High $2,454.71 | Facility | None | $87.10 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $112.20 Median $165.96 Typical High $1,071.52 | Professional | None | $112.20 | $165.96 | $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 $87.10 Median $134.90 Typical High $229.09 | Professional | None | $87.10 | $134.90 | $229.09 |
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 $51.29 Median $57.54 Typical High $74.13 | Professional | 52 · Reduced service | $51.29 | $57.54 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $22.91 Typical High $29.51 | Professional | 53 · Discontinued | $20.42 | $22.91 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $87.10 Typical High $112.20 | Professional | 54 · Surgery only | $75.86 | $87.10 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $17.38 Typical High $22.39 | Professional | 55 · Aftercare only | $15.49 | $17.38 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $11.48 Typical High $14.79 | Professional | 56 · Pre-op care only | $10.23 | $11.48 | $14.79 |
Where Virginia sits
The same service costs 3.7 times more in Alaska than in Florida. 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· 35th of 51
$138
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.