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 $812.83 Typical High $8,317.64 | Facility | None | $74.13 | $812.83 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $102.33 Typical High $158.49 | Professional | None | $60.26 | $102.33 | $158.49 |
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 $56.23 Median $89.13 Typical High $128.82 | Professional | None | $56.23 | $89.13 | $128.82 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $85.11 Median $134.90 Typical High $190.55 | Professional | 50 · Both sides | $85.11 | $134.90 | $190.55 |
CareFirst Setting Professional Modifier None Typical Low $60.26 Median $66.07 Typical High $77.62 | Professional | None | $60.26 | $66.07 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $81.28 Typical High $1,288.25 | Facility | None | $50.12 | $81.28 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $91.20 Typical High $141.25 | Professional | None | $57.54 | $91.20 | $141.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $102.33 Median $123.03 Typical High $154.88 | Professional | None | $102.33 | $123.03 | $154.88 |
Medcost Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Medcost Setting Facility Modifier None Typical Low $69.18 Median $102.33 Typical High $165.96 | Facility | None | $69.18 | $102.33 | $165.96 |
Medcost Setting Professional Modifier None Typical Low $50.12 Median $61.66 Typical High $123.03 | Professional | None | $50.12 | $61.66 | $123.03 |
Sentara Setting Facility Modifier None Typical Low $60.26 Median $371.54 Typical High $2,454.71 | Facility | None | $60.26 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $95.50 Median $120.23 Typical High $234.42 | Professional | None | $95.50 | $120.23 | $234.42 |
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 $46.77 Median $83.18 Typical High $151.36 | Professional | None | $46.77 | $83.18 | $151.36 |
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 $30.20 Median $46.77 Typical High $52.48 | Professional | 52 · Reduced service | $30.20 | $46.77 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $18.62 Typical High $20.89 | Professional | 53 · Discontinued | $12.02 | $18.62 | $20.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $70.79 Typical High $79.43 | Professional | 54 · Surgery only | $45.71 | $70.79 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $14.13 Typical High $15.85 | Professional | 55 · Aftercare only | $9.12 | $14.13 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $9.33 Typical High $10.47 | Professional | 56 · Pre-op care only | $6.03 | $9.33 | $10.47 |
Where Virginia sits
The same service costs 3.7 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· 39th of 51
$93.33
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.