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 $3.39 Median $2,041.74 Typical High $8,317.64 | Facility | None | $3.39 | $2,041.74 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $2.00 Median $6.31 Typical High $11.22 | Professional | None | $2.00 | $6.31 | $11.22 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.24 Median $6.31 Typical High $8.71 | Professional | None | $2.24 | $6.31 | $8.71 |
CareFirst Setting Professional Modifier None Typical Low $2.00 Median $2.19 Typical High $2.57 | Professional | None | $2.00 | $2.19 | $2.57 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $1,174.90 Typical High $2,691.53 | Facility | None | $50.12 | $1,174.90 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1.86 Median $6.61 Typical High $10.00 | Professional | None | $1.86 | $6.61 | $10.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5.89 Median $7.76 Typical High $9.12 | Professional | None | $5.89 | $7.76 | $9.12 |
Medcost Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $16.60 | Professional | None | $14.13 | $14.13 | $16.60 |
Medcost Setting Facility Modifier None Typical Low $2.75 Median $6.17 Typical High $10.23 | Facility | None | $2.75 | $6.17 | $10.23 |
Medcost Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | None | $22.91 | $22.91 | $22.91 |
Sentara Setting Facility Modifier None Typical Low $2.29 Median $302.00 Typical High $1,819.70 | Facility | None | $2.29 | $302.00 | $1,819.70 |
Sentara Setting Professional Modifier None Typical Low $6.61 Median $8.71 Typical High $1,071.52 | Professional | None | $6.61 | $8.71 | $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 $1.91 Median $5.50 Typical High $12.02 | Professional | None | $1.91 | $5.50 | $12.02 |
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 $1.00 Median $2.45 Typical High $3.55 | Professional | 52 · Reduced service | $1.00 | $2.45 | $3.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.40 Median $0.98 Typical High $1.41 | Professional | 53 · Discontinued | $0.40 | $0.98 | $1.41 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1.48 Median $3.63 Typical High $5.25 | Professional | 54 · Surgery only | $1.48 | $3.63 | $5.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.30 Median $0.72 Typical High $1.07 | Professional | 55 · Aftercare only | $0.30 | $0.72 | $1.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.20 Median $0.49 Typical High $0.71 | Professional | 56 · Pre-op care only | $0.20 | $0.49 | $0.71 |
Where Virginia sits
The same service costs 3.0 times more in Alaska than in Nebraska. 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· 25th of 51
$6.61
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.