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 $44.67 Median $50.12 Typical High $93.33 | Facility | None | $44.67 | $50.12 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $70.79 Typical High $93.33 | Professional | None | $44.67 | $70.79 | $93.33 |
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 $40.74 Median $48.98 Typical High $58.88 | Professional | None | $40.74 | $48.98 | $58.88 |
CareFirst Setting Professional Modifier None Typical Low $34.67 Median $38.90 Typical High $45.71 | Professional | None | $34.67 | $38.90 | $45.71 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $75.86 Typical High $141.25 | Facility | None | $50.12 | $75.86 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $79.43 Typical High $117.49 | Professional | None | $42.66 | $79.43 | $117.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $95.50 Median $114.82 Typical High $147.91 | Professional | None | $95.50 | $114.82 | $147.91 |
Medcost Setting Professional Modifier None Typical Low $95.50 Median $120.23 Typical High $120.23 | Professional | None | $95.50 | $120.23 | $120.23 |
Medcost Setting Facility Modifier None Typical Low $50.12 Median $81.28 Typical High $154.88 | Facility | None | $50.12 | $81.28 | $154.88 |
Medcost Setting Professional Modifier None Typical Low $30.90 Median $37.15 Typical High $93.33 | Professional | None | $30.90 | $37.15 | $93.33 |
Sentara Setting Facility Modifier None Typical Low $38.90 Median $281.84 Typical High $2,454.71 | Facility | None | $38.90 | $281.84 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $60.26 Median $100.00 Typical High $204.17 | Professional | None | $60.26 | $100.00 | $204.17 |
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 $33.88 Median $63.10 Typical High $128.82 | Professional | None | $33.88 | $63.10 | $128.82 |
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 $22.39 Median $35.48 Typical High $46.77 | Professional | 52 · Reduced service | $22.39 | $35.48 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $14.13 Typical High $18.62 | Professional | 53 · Discontinued | $8.91 | $14.13 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $10.47 Typical High $14.13 | Professional | 55 · Aftercare only | $6.76 | $10.47 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $7.08 Typical High $9.33 | Professional | 56 · Pre-op care only | $4.47 | $7.08 | $9.33 |
Where Virginia sits
The same service costs 3.9 times more in Alaska than in Virginia. 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· 51st of 51
$52.48
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.