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 $51.29 Median $79.43 Typical High $117.49 | Facility | None | $51.29 | $79.43 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $67.61 Typical High $83.18 | Professional | None | $44.67 | $67.61 | $83.18 |
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 $42.66 Median $60.26 Typical High $102.33 | Professional | None | $42.66 | $60.26 | $102.33 |
CareFirst Setting Professional Modifier None Typical Low $35.48 Median $38.90 Typical High $45.71 | Professional | None | $35.48 | $38.90 | $45.71 |
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 $42.66 Median $69.18 Typical High $100.00 | Professional | None | $42.66 | $69.18 | $100.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $81.28 Median $107.15 Typical High $128.82 | Professional | None | $81.28 | $107.15 | $128.82 |
Medcost Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $112.20 | Professional | None | $95.50 | $95.50 | $112.20 |
Medcost Setting Facility Modifier None Typical Low $51.29 Median $77.62 Typical High $128.82 | Facility | None | $51.29 | $77.62 | $128.82 |
Medcost Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
Sentara Setting Facility Modifier None Typical Low $44.67 Median $281.84 Typical High $2,454.71 | Facility | None | $44.67 | $281.84 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $70.79 Median $85.11 Typical High $1,071.52 | Professional | None | $70.79 | $85.11 | $1,071.52 |
United Setting Facility Modifier None Typical Low $100.00 Median $660.69 Typical High $2,041.74 | Facility | None | $100.00 | $660.69 | $2,041.74 |
United Setting Professional Modifier None Typical Low $39.81 Median $64.57 Typical High $112.20 | Professional | None | $39.81 | $64.57 | $112.20 |
4 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 $22.39 Median $28.18 Typical High $40.74 | Professional | 52 · Reduced service | $22.39 | $28.18 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $11.22 Typical High $16.22 | Professional | 53 · Discontinued | $9.12 | $11.22 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $8.32 Typical High $12.02 | Professional | 55 · Aftercare only | $6.76 | $8.32 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $5.62 Typical High $8.13 | Professional | 56 · Pre-op care only | $4.47 | $5.62 | $8.13 |
Where Virginia sits
The same service costs 3.3 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· 35th of 51
$70.79
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.