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 $95.50 Median $3,801.89 Typical High $9,332.54 | Facility | None | $95.50 | $3,801.89 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $194.98 Typical High $234.42 | Professional | None | $51.29 | $194.98 | $234.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $47.86 Median $57.54 Typical High $69.18 | Professional | None | $47.86 | $57.54 | $69.18 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $70.79 Median $85.11 Typical High $104.71 | Professional | 50 · Both sides | $70.79 | $85.11 | $104.71 |
CareFirst Setting Professional Modifier None Typical Low $50.12 Median $54.95 Typical High $66.07 | Professional | None | $50.12 | $54.95 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,230.27 Typical High $2,691.53 | Facility | None | $512.86 | $1,230.27 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $154.88 Typical High $251.19 | Professional | None | $50.12 | $154.88 | $251.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $204.17 Median $245.47 Typical High $309.03 | Professional | None | $204.17 | $245.47 | $309.03 |
Medcost Setting Professional Modifier None Typical Low $208.93 Median $263.03 Typical High $549.54 | Professional | None | $208.93 | $263.03 | $549.54 |
Medcost Setting Facility Modifier None Typical Low $58.88 Median $97.72 Typical High $331.13 | Facility | None | $58.88 | $97.72 | $331.13 |
Medcost Setting Professional Modifier None Typical Low $72.44 Median $131.83 Typical High $194.98 | Professional | None | $72.44 | $131.83 | $194.98 |
Sentara Setting Facility Modifier None Typical Low $50.12 Median $302.00 Typical High $2,454.71 | Facility | None | $50.12 | $302.00 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $173.78 Median $234.42 Typical High $524.81 | Professional | None | $173.78 | $234.42 | $524.81 |
United Setting Facility Modifier None Typical Low $100.00 Median $660.69 Typical High $2,089.30 | Facility | None | $100.00 | $660.69 | $2,089.30 |
United Setting Professional Modifier None Typical Low $39.81 Median $128.82 Typical High $295.12 | Professional | None | $39.81 | $128.82 | $295.12 |
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 $25.70 Median $70.79 Typical High $117.49 | Professional | 52 · Reduced service | $25.70 | $70.79 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $28.18 Typical High $46.77 | Professional | 53 · Discontinued | $10.23 | $28.18 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $104.71 Typical High $177.83 | Professional | 54 · Surgery only | $38.90 | $104.71 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $20.89 Typical High $35.48 | Professional | 55 · Aftercare only | $7.76 | $20.89 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $14.13 Typical High $23.44 | Professional | 56 · Pre-op care only | $5.13 | $14.13 | $23.44 |
Where Virginia sits
The same service costs 4.6 times more in Iowa 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· 50th of 51
$64.57
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.