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 $33.11 Median $1,348.96 Typical High $8,317.64 | Facility | None | $33.11 | $1,348.96 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $32.36 Typical High $47.86 | Professional | None | $24.55 | $32.36 | $47.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $22.91 Median $30.20 Typical High $41.69 | Professional | None | $22.91 | $30.20 | $41.69 |
CareFirst Setting Professional Modifier None Typical Low $23.44 Median $26.30 Typical High $30.90 | Professional | None | $23.44 | $26.30 | $30.90 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $707.95 Typical High $2,691.53 | Facility | None | $389.05 | $707.95 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $22.91 Median $30.90 Typical High $48.98 | Professional | None | $22.91 | $30.90 | $48.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $30.20 Median $39.81 Typical High $46.77 | Professional | None | $30.20 | $39.81 | $46.77 |
Medcost Setting Facility Modifier None Typical Low $28.84 Median $38.02 Typical High $63.10 | Facility | None | $28.84 | $38.02 | $63.10 |
Medcost Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
Sentara Setting Facility Modifier None Typical Low $23.99 Median $173.78 Typical High $2,454.71 | Facility | None | $23.99 | $173.78 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $33.11 Median $42.66 Typical High $1,071.52 | Professional | None | $33.11 | $42.66 | $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 $22.39 Median $33.11 Typical High $57.54 | Professional | None | $22.39 | $33.11 | $57.54 |
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 $12.30 Median $14.45 Typical High $19.05 | Professional | 52 · Reduced service | $12.30 | $14.45 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $5.75 Typical High $7.76 | Professional | 53 · Discontinued | $4.90 | $5.75 | $7.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $18.20 Median $21.38 Typical High $28.84 | Professional | 54 · Surgery only | $18.20 | $21.38 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $4.27 Typical High $5.75 | Professional | 55 · Aftercare only | $3.63 | $4.27 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.88 Typical High $3.80 | Professional | 56 · Pre-op care only | $2.45 | $2.88 | $3.80 |
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· 40th of 51
$32.36
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.