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 $74.13 Median $4,073.80 Typical High $10,000.00 | Facility | None | $74.13 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $93.33 Typical High $120.23 | Professional | None | $67.61 | $93.33 | $120.23 |
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 $63.10 Median $85.11 Typical High $117.49 | Professional | None | $63.10 | $85.11 | $117.49 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $93.33 Median $125.89 Typical High $173.78 | Professional | 50 · Both sides | $93.33 | $125.89 | $173.78 |
CareFirst Setting Professional Modifier None Typical Low $58.88 Median $66.07 Typical High $77.62 | Professional | None | $58.88 | $66.07 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $69.18 Typical High $794.33 | Facility | None | $50.12 | $69.18 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $85.11 Typical High $128.82 | Professional | None | $64.57 | $85.11 | $128.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $91.20 Median $109.65 Typical High $138.04 | Professional | None | $91.20 | $109.65 | $138.04 |
Medcost Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
Medcost Setting Facility Modifier None Typical Low $74.13 Median $93.33 Typical High $151.36 | Facility | None | $74.13 | $93.33 | $151.36 |
Medcost Setting Professional Modifier None Typical Low $75.86 Median $79.43 Typical High $100.00 | Professional | None | $75.86 | $79.43 | $100.00 |
Sentara Setting Facility Modifier None Typical Low $57.54 Median $371.54 Typical High $2,454.71 | Facility | None | $57.54 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $85.11 Median $97.72 Typical High $204.17 | Professional | None | $85.11 | $97.72 | $204.17 |
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 $51.29 Median $75.86 Typical High $144.54 | Professional | None | $51.29 | $75.86 | $144.54 |
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 $33.88 Median $41.69 Typical High $46.77 | Professional | 52 · Reduced service | $33.88 | $41.69 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $16.60 Typical High $18.62 | Professional | 53 · Discontinued | $13.49 | $16.60 | $18.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $63.10 Typical High $70.79 | Professional | 54 · Surgery only | $51.29 | $63.10 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $12.59 Typical High $14.13 | Professional | 55 · Aftercare only | $10.23 | $12.59 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $8.32 Typical High $9.33 | Professional | 56 · Pre-op care only | $6.76 | $8.32 | $9.33 |
Where Virginia sits
The same service costs 3.8 times more in Alaska than in Kentucky. 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· 37th of 51
$87.10
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.