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 $660.69 Median $5,248.07 Typical High $10,000.00 | Facility | None | $660.69 | $5,248.07 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $3,981.07 | Professional | None | $660.69 | $660.69 | $3,981.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $6,456.54 Typical High $7,244.36 | Facility | None | $4,677.35 | $6,456.54 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $158.49 Median $190.55 Typical High $229.09 | Professional | None | $158.49 | $190.55 | $229.09 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $239.88 Median $281.84 Typical High $346.74 | Professional | 50 · Both sides | $239.88 | $281.84 | $346.74 |
CareFirst Setting Professional Modifier None Typical Low $933.25 Median $1,047.13 Typical High $1,230.27 | Professional | None | $933.25 | $1,047.13 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,995.26 Typical High $3,715.35 | Facility | None | $524.81 | $1,995.26 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $524.81 | Professional | None | $223.87 | $223.87 | $524.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,019.95 Median $3,311.31 Typical High $3,311.31 | Professional | None | $3,019.95 | $3,311.31 | $3,311.31 |
Medcost Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $1,000.00 | Facility | None | $660.69 | $660.69 | $1,000.00 |
Sentara Setting Facility Modifier None Typical Low $588.84 Median $2,630.27 Typical High $10,964.78 | Facility | None | $588.84 | $2,630.27 | $10,964.78 |
Sentara Setting Professional Modifier None Typical Low $588.84 Median $758.58 Typical High $10,964.78 | Professional | None | $588.84 | $758.58 | $10,964.78 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $6,760.83 Typical High $16,595.87 | Facility | None | $1,548.82 | $6,760.83 | $16,595.87 |
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 $331.13 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $331.13 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $66.07 |
Where Virginia sits
The same service costs 67.6 times more in Oklahoma than in Montana. 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· 49th of 51
$214
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.