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 $114.82 Median $128.82 Typical High $162.18 | Facility | None | $114.82 | $128.82 | $162.18 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $151.36 Typical High $208.93 | Professional | None | $114.82 | $151.36 | $208.93 |
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 $104.71 Median $125.89 Typical High $151.36 | Professional | None | $104.71 | $125.89 | $151.36 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $158.49 Median $190.55 Typical High $229.09 | Professional | 50 · Both sides | $158.49 | $190.55 | $229.09 |
CareFirst Setting Professional Modifier None Typical Low $89.13 Median $97.72 Typical High $114.82 | Professional | None | $89.13 | $97.72 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $75.86 Typical High $138.04 | Facility | None | $50.12 | $75.86 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $144.54 Typical High $218.78 | Professional | None | $107.15 | $144.54 | $218.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $141.25 Median $169.82 Typical High $213.80 | Professional | None | $141.25 | $169.82 | $213.80 |
Medcost Setting Professional Modifier None Typical Low $194.98 Median $245.47 Typical High $245.47 | Professional | None | $194.98 | $245.47 | $245.47 |
Medcost Setting Facility Modifier None Typical Low $128.82 Median $169.82 Typical High $263.03 | Facility | None | $128.82 | $169.82 | $263.03 |
Medcost Setting Professional Modifier None Typical Low $75.86 Median $79.43 Typical High $181.97 | Professional | None | $75.86 | $79.43 | $181.97 |
Sentara Setting Facility Modifier None Typical Low $104.71 Median $309.03 Typical High $2,454.71 | Facility | None | $104.71 | $309.03 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $107.15 Median $173.78 Typical High $346.74 | Professional | None | $107.15 | $173.78 | $346.74 |
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 $87.10 Median $125.89 Typical High $245.47 | Professional | None | $87.10 | $125.89 | $245.47 |
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 $57.54 Median $70.79 Typical High $81.28 | Professional | 52 · Reduced service | $57.54 | $70.79 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $28.18 Typical High $32.36 | Professional | 53 · Discontinued | $22.91 | $28.18 | $32.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $21.38 Typical High $24.55 | Professional | 55 · Aftercare only | $16.98 | $21.38 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $14.13 Typical High $16.22 | Professional | 56 · Pre-op care only | $11.48 | $14.13 | $16.22 |
Where Virginia sits
The same service costs 4.3 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· 45th of 51
$132
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.