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 $46.77 Median $93.33 Typical High $7,079.46 | Facility | None | $46.77 | $93.33 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $54.95 Typical High $89.13 | Professional | None | $38.02 | $54.95 | $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 $34.67 Median $48.98 Typical High $69.18 | Professional | None | $34.67 | $48.98 | $69.18 |
CareFirst Setting Professional Modifier None Typical Low $37.15 Median $41.69 Typical High $48.98 | Professional | None | $37.15 | $41.69 | $48.98 |
Cigna Setting Facility Modifier None Typical Low $28.18 Median $77.62 Typical High $1,621.81 | Facility | None | $28.18 | $77.62 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $51.29 Typical High $77.62 | Professional | None | $35.48 | $51.29 | $77.62 |
Kaiser Permanente Setting Professional Modifier None Typical Low $50.12 Median $60.26 Typical High $75.86 | Professional | None | $50.12 | $60.26 | $75.86 |
Medcost Setting Professional Modifier None Typical Low $69.18 Median $87.10 Typical High $87.10 | Professional | None | $69.18 | $87.10 | $87.10 |
Medcost Setting Facility Modifier None Typical Low $42.66 Median $61.66 Typical High $100.00 | Facility | None | $42.66 | $61.66 | $100.00 |
Medcost Setting Professional Modifier None Typical Low $52.48 Median $57.54 Typical High $64.57 | Professional | None | $52.48 | $57.54 | $64.57 |
Sentara Setting Facility Modifier None Typical Low $33.11 Median $371.54 Typical High $2,454.71 | Facility | None | $33.11 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $42.66 Median $66.07 Typical High $131.83 | Professional | None | $42.66 | $66.07 | $131.83 |
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 $28.18 Median $46.77 Typical High $89.13 | Professional | None | $28.18 | $46.77 | $89.13 |
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 $18.62 Median $25.12 Typical High $30.90 | Professional | 52 · Reduced service | $18.62 | $25.12 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $10.00 Typical High $12.30 | Professional | 53 · Discontinued | $7.59 | $10.00 | $12.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.18 Median $38.02 Typical High $45.71 | Professional | 54 · Surgery only | $28.18 | $38.02 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $7.59 Typical High $9.33 | Professional | 55 · Aftercare only | $5.62 | $7.59 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $5.01 Typical High $6.17 | Professional | 56 · Pre-op care only | $3.80 | $5.01 | $6.17 |
Where Virginia sits
The same service costs 4.2 times more in Alaska 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· 43rd of 51
$51.29
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.