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 $56.23 Median $4,365.16 Typical High $14,125.38 | Facility | None | $56.23 | $4,365.16 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $77.62 Typical High $87.10 | Professional | None | $51.29 | $77.62 | $87.10 |
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 $45.71 Median $56.23 Typical High $67.61 | Professional | None | $45.71 | $56.23 | $67.61 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $58.88 Median $81.28 Typical High $97.72 | Professional | 50 · Both sides | $58.88 | $81.28 | $97.72 |
CareFirst Setting Professional Modifier None Typical Low $39.81 Median $43.65 Typical High $52.48 | Professional | None | $39.81 | $43.65 | $52.48 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $69.18 Typical High $120.23 | Facility | None | $50.12 | $69.18 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $74.13 Typical High $109.65 | Professional | None | $48.98 | $74.13 | $109.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $81.28 Median $97.72 Typical High $123.03 | Professional | None | $81.28 | $97.72 | $123.03 |
Medcost Setting Professional Modifier None Typical Low $79.43 Median $100.00 Typical High $100.00 | Professional | None | $79.43 | $100.00 | $100.00 |
Medcost Setting Facility Modifier None Typical Low $56.23 Median $87.10 Typical High $144.54 | Facility | None | $56.23 | $87.10 | $144.54 |
Medcost Setting Professional Modifier None Typical Low $51.29 Median $57.54 Typical High $85.11 | Professional | None | $51.29 | $57.54 | $85.11 |
Sentara Setting Facility Modifier None Typical Low $42.66 Median $295.12 Typical High $2,454.71 | Facility | None | $42.66 | $295.12 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $52.48 Median $89.13 Typical High $190.55 | Professional | None | $52.48 | $89.13 | $190.55 |
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 $37.15 Median $61.66 Typical High $120.23 | Professional | None | $37.15 | $61.66 | $120.23 |
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 $37.15 Typical High $43.65 | Professional | 52 · Reduced service | $25.70 | $37.15 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $14.79 Typical High $17.38 | Professional | 53 · Discontinued | $10.23 | $14.79 | $17.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $54.95 Typical High $66.07 | Professional | 54 · Surgery only | $38.90 | $54.95 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $10.96 Typical High $13.18 | Professional | 55 · Aftercare only | $7.76 | $10.96 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $7.41 Typical High $8.71 | Professional | 56 · Pre-op care only | $5.13 | $7.41 | $8.71 |
Where Virginia sits
The same service costs 3.6 times more in Alaska 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
$60.26
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.