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 $67.61 Median $3,801.89 Typical High $9,332.54 | Facility | None | $67.61 | $3,801.89 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $67.61 Typical High $97.72 | Professional | None | $41.69 | $67.61 | $97.72 |
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 $38.90 Median $58.88 Typical High $85.11 | Professional | None | $38.90 | $58.88 | $85.11 |
CareFirst Setting Professional Modifier None Typical Low $41.69 Median $45.71 Typical High $53.70 | Professional | None | $41.69 | $45.71 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $42.66 Median $114.82 Typical High $1,621.81 | Facility | None | $42.66 | $114.82 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $60.26 Typical High $91.20 | Professional | None | $39.81 | $60.26 | $91.20 |
Kaiser Permanente Setting Professional Modifier None Typical Low $66.07 Median $79.43 Typical High $100.00 | Professional | None | $66.07 | $79.43 | $100.00 |
Medcost Setting Professional Modifier None Typical Low $75.86 Median $93.33 Typical High $93.33 | Professional | None | $75.86 | $93.33 | $93.33 |
Medcost Setting Facility Modifier None Typical Low $46.77 Median $67.61 Typical High $109.65 | Facility | None | $46.77 | $67.61 | $109.65 |
Medcost Setting Professional Modifier None Typical Low $50.12 Median $63.10 Typical High $70.79 | Professional | None | $50.12 | $63.10 | $70.79 |
Sentara Setting Facility Modifier None Typical Low $41.69 Median $371.54 Typical High $2,454.71 | Facility | None | $41.69 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $52.48 Median $72.44 Typical High $151.36 | Professional | None | $52.48 | $72.44 | $151.36 |
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 $30.90 Median $52.48 Typical High $97.72 | Professional | None | $30.90 | $52.48 | $97.72 |
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 $20.89 Median $30.90 Typical High $33.88 | Professional | 52 · Reduced service | $20.89 | $30.90 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $12.30 Typical High $13.49 | Professional | 53 · Discontinued | $8.32 | $12.30 | $13.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $46.77 Typical High $51.29 | Professional | 54 · Surgery only | $31.62 | $46.77 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $9.33 Typical High $10.23 | Professional | 55 · Aftercare only | $6.31 | $9.33 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $6.17 Typical High $6.76 | Professional | 56 · Pre-op care only | $4.17 | $6.17 | $6.76 |
Where Virginia sits
The same service costs 3.5 times more in Alaska than in Florida. 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
$61.66
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.