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 $52.48 Median $4,365.16 Typical High $14,125.38 | Facility | None | $52.48 | $4,365.16 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $52.48 Typical High $89.13 | Professional | None | $42.66 | $52.48 | $89.13 |
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 $39.81 Median $47.86 Typical High $58.88 | Professional | None | $39.81 | $47.86 | $58.88 |
CareFirst Setting Professional Modifier None Typical Low $36.31 Median $40.74 Typical High $47.86 | Professional | None | $36.31 | $40.74 | $47.86 |
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 $41.69 Median $44.67 Typical High $85.11 | Professional | None | $41.69 | $44.67 | $85.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $37.15 Median $43.65 Typical High $52.48 | Professional | None | $37.15 | $43.65 | $52.48 |
Medcost Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $165.96 | Professional | None | $147.91 | $147.91 | $165.96 |
Medcost Setting Facility Modifier None Typical Low $52.48 Median $64.57 Typical High $85.11 | Facility | None | $52.48 | $64.57 | $85.11 |
Medcost Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
Sentara Setting Facility Modifier None Typical Low $46.77 Median $223.87 Typical High $2,454.71 | Facility | None | $46.77 | $223.87 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $47.86 Median $63.10 Typical High $1,071.52 | Professional | None | $47.86 | $63.10 | $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 $38.02 Median $53.70 Typical High $112.20 | Professional | None | $38.02 | $53.70 | $112.20 |
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 $21.38 Median $22.91 Typical High $26.30 | Professional | 52 · Reduced service | $21.38 | $22.91 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $9.12 Typical High $10.47 | Professional | 53 · Discontinued | $8.51 | $9.12 | $10.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $33.88 Typical High $38.90 | Professional | 54 · Surgery only | $31.62 | $33.88 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.92 Typical High $7.76 | Professional | 55 · Aftercare only | $6.31 | $6.92 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.57 Typical High $5.25 | Professional | 56 · Pre-op care only | $4.27 | $4.57 | $5.25 |
Where Virginia sits
The same service costs 13.8 times more in Oklahoma than in New York. 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· 41st of 51
$52.48
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.