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 $104.71 Median $354.81 Typical High $8,317.64 | Facility | None | $104.71 | $354.81 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $162.18 Typical High $288.40 | Professional | None | $72.44 | $162.18 | $288.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $67.61 Median $81.28 Typical High $109.65 | Professional | None | $67.61 | $81.28 | $109.65 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $100.00 Median $120.23 Typical High $165.96 | Professional | 50 · Both sides | $100.00 | $120.23 | $165.96 |
CareFirst Setting Professional Modifier None Typical Low $69.18 Median $77.62 Typical High $100.00 | Professional | None | $69.18 | $77.62 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $169.82 Typical High $295.12 | Professional | None | $70.79 | $169.82 | $295.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $181.97 Median $213.80 Typical High $275.42 | Professional | None | $181.97 | $213.80 | $275.42 |
Medcost Setting Professional Modifier None Typical Low $234.42 Median $288.40 Typical High $602.56 | Professional | None | $234.42 | $288.40 | $602.56 |
Medcost Setting Facility Modifier None Typical Low $107.15 Median $138.04 Typical High $309.03 | Facility | None | $107.15 | $138.04 | $309.03 |
Medcost Setting Professional Modifier None Typical Low $93.33 Median $186.21 Typical High $208.93 | Professional | None | $93.33 | $186.21 | $208.93 |
Sentara Setting Facility Modifier None Typical Low $66.07 Median $141.25 Typical High $10,232.93 | Facility | None | $66.07 | $141.25 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $177.83 Median $251.19 Typical High $512.86 | Professional | None | $177.83 | $251.19 | $512.86 |
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 $69.18 Median $151.36 Typical High $331.13 | Professional | None | $69.18 | $151.36 | $331.13 |
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 $36.31 Median $58.88 Typical High $107.15 | Professional | 52 · Reduced service | $36.31 | $58.88 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $23.44 Typical High $42.66 | Professional | 53 · Discontinued | $14.45 | $23.44 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $89.13 Typical High $158.49 | Professional | 54 · Surgery only | $54.95 | $89.13 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $17.78 Typical High $31.62 | Professional | 55 · Aftercare only | $10.96 | $17.78 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $11.75 Typical High $21.38 | Professional | 56 · Pre-op care only | $7.24 | $11.75 | $21.38 |
Where Virginia sits
The same service costs 3.8 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
$95.50
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.