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 $77.62 Median $4,365.16 Typical High $14,125.38 | Facility | None | $77.62 | $4,365.16 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $100.00 Typical High $109.65 | Professional | None | $72.44 | $100.00 | $109.65 |
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 $66.07 Median $79.43 Typical High $95.50 | Professional | None | $66.07 | $79.43 | $95.50 |
CareFirst Setting Professional Modifier None Typical Low $56.23 Median $63.10 Typical High $74.13 | Professional | None | $56.23 | $63.10 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $83.18 Typical High $154.88 | Facility | None | $50.12 | $83.18 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $93.33 Typical High $141.25 | Professional | None | $69.18 | $93.33 | $141.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $109.65 Median $131.83 Typical High $169.82 | Professional | None | $109.65 | $131.83 | $169.82 |
Medcost Setting Professional Modifier None Typical Low $112.20 Median $141.25 Typical High $141.25 | Professional | None | $112.20 | $141.25 | $141.25 |
Medcost Setting Facility Modifier None Typical Low $77.62 Median $107.15 Typical High $181.97 | Facility | None | $77.62 | $107.15 | $181.97 |
Medcost Setting Professional Modifier None Typical Low $75.86 Median $87.10 Typical High $104.71 | Professional | None | $75.86 | $87.10 | $104.71 |
Sentara Setting Facility Modifier None Typical Low $54.95 Median $371.54 Typical High $2,454.71 | Facility | None | $54.95 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $69.18 Median $114.82 Typical High $234.42 | Professional | None | $69.18 | $114.82 | $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 $50.12 Median $79.43 Typical High $154.88 | Professional | None | $50.12 | $79.43 | $154.88 |
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 $47.86 Typical High $54.95 | Professional | 52 · Reduced service | $36.31 | $47.86 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $19.50 Typical High $21.88 | Professional | 53 · Discontinued | $14.45 | $19.50 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $72.44 Typical High $83.18 | Professional | 54 · Surgery only | $54.95 | $72.44 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $14.45 Typical High $16.60 | Professional | 55 · Aftercare only | $10.96 | $14.45 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $9.55 Typical High $10.96 | Professional | 56 · Pre-op care only | $7.24 | $9.55 | $10.96 |
Where Virginia sits
The same service costs 3.8 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· 47th of 51
$83.18
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.