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 $63.10 Typical High $87.10 | Facility | None | $56.23 | $63.10 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $79.43 Typical High $123.03 | Professional | None | $56.23 | $79.43 | $123.03 |
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 $51.29 Median $60.26 Typical High $74.13 | Professional | None | $51.29 | $60.26 | $74.13 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $75.86 Median $91.20 Typical High $109.65 | Professional | 50 · Both sides | $75.86 | $91.20 | $109.65 |
CareFirst Setting Professional Modifier None Typical Low $43.65 Median $47.86 Typical High $63.10 | Professional | None | $43.65 | $47.86 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $58.88 Typical High $102.33 | Facility | None | $50.12 | $58.88 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $75.86 Typical High $123.03 | Professional | None | $53.70 | $75.86 | $123.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $79.43 Median $95.50 Typical High $120.23 | Professional | None | $79.43 | $95.50 | $120.23 |
Medcost Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $147.91 | Professional | None | $117.49 | $147.91 | $147.91 |
Medcost Setting Facility Modifier None Typical Low $63.10 Median $93.33 Typical High $141.25 | Facility | None | $63.10 | $93.33 | $141.25 |
Medcost Setting Professional Modifier None Typical Low $79.43 Median $100.00 Typical High $112.20 | Professional | None | $79.43 | $100.00 | $112.20 |
Sentara Setting Facility Modifier None Typical Low $53.70 Median $371.54 Typical High $2,454.71 | Facility | None | $53.70 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $64.57 Median $102.33 Typical High $186.21 | Professional | None | $64.57 | $102.33 | $186.21 |
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 $42.66 Median $70.79 Typical High $131.83 | Professional | None | $42.66 | $70.79 | $131.83 |
4 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 $28.18 Median $36.31 Typical High $42.66 | Professional | 52 · Reduced service | $28.18 | $36.31 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $14.45 Typical High $17.38 | Professional | 53 · Discontinued | $11.22 | $14.45 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $10.96 Typical High $12.88 | Professional | 55 · Aftercare only | $8.32 | $10.96 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $7.24 Typical High $8.71 | Professional | 56 · Pre-op care only | $5.62 | $7.24 | $8.71 |
Where Virginia sits
The same service costs 3.5 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· 50th 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.