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 $70.79 Median $275.42 Typical High $8,317.64 | Facility | None | $70.79 | $275.42 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $134.90 Typical High $251.19 | Professional | None | $50.12 | $134.90 | $251.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $45.71 Median $54.95 Typical High $75.86 | Professional | None | $45.71 | $54.95 | $75.86 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $69.18 Median $83.18 Typical High $112.20 | Professional | 50 · Both sides | $69.18 | $83.18 | $112.20 |
CareFirst Setting Professional Modifier None Typical Low $47.86 Median $52.48 Typical High $69.18 | Professional | None | $47.86 | $52.48 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $134.90 Typical High $251.19 | Professional | None | $47.86 | $134.90 | $251.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $181.97 Typical High $229.09 | Professional | None | $154.88 | $181.97 | $229.09 |
Medcost Setting Professional Modifier None Typical Low $208.93 Median $257.04 Typical High $257.04 | Professional | None | $208.93 | $257.04 | $257.04 |
Medcost Setting Facility Modifier None Typical Low $74.13 Median $93.33 Typical High $251.19 | Facility | None | $74.13 | $93.33 | $251.19 |
Medcost Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $186.21 | Professional | None | $74.13 | $74.13 | $186.21 |
Sentara Setting Facility Modifier None Typical Low $44.67 Median $97.72 Typical High $10,232.93 | Facility | None | $44.67 | $97.72 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $141.25 Median $213.80 Typical High $446.68 | Professional | None | $141.25 | $213.80 | $446.68 |
United Setting Facility Modifier None Typical Low $204.17 Median $1,023.29 Typical High $2,398.83 | Facility | None | $204.17 | $1,023.29 | $2,398.83 |
United Setting Professional Modifier None Typical Low $46.77 Median $125.89 Typical High $269.15 | Professional | None | $46.77 | $125.89 | $269.15 |
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 $25.12 Median $40.74 Typical High $89.13 | Professional | 52 · Reduced service | $25.12 | $40.74 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $21.88 Typical High $35.48 | Professional | 53 · Discontinued | $10.00 | $21.88 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $60.26 Typical High $134.90 | Professional | 54 · Surgery only | $37.15 | $60.26 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $12.30 Typical High $26.92 | Professional | 55 · Aftercare only | $7.59 | $12.30 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $8.13 Typical High $17.78 | Professional | 56 · Pre-op care only | $5.01 | $8.13 | $17.78 |
Where Virginia sits
The same service costs 3.9 times more in Alaska than in Virginia. 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· 51st of 51
$66.07
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.