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 $45.71 Median $50.12 Typical High $70.79 | Facility | None | $45.71 | $50.12 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $60.26 Typical High $70.79 | Professional | None | $45.71 | $60.26 | $70.79 |
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 $41.69 Median $50.12 Typical High $60.26 | Professional | None | $41.69 | $50.12 | $60.26 |
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 $38.90 Median $50.12 Typical High $75.86 | Facility | None | $38.90 | $50.12 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $63.10 Typical High $89.13 | Professional | None | $43.65 | $63.10 | $89.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $64.57 Median $77.62 Typical High $97.72 | Professional | None | $64.57 | $77.62 | $97.72 |
Medcost Setting Professional Modifier None Typical Low $83.18 Median $104.71 Typical High $104.71 | Professional | None | $83.18 | $104.71 | $104.71 |
Medcost Setting Facility Modifier None Typical Low $50.12 Median $70.79 Typical High $114.82 | Facility | None | $50.12 | $70.79 | $114.82 |
Medcost Setting Professional Modifier None Typical Low $30.90 Median $37.15 Typical High $77.62 | Professional | None | $30.90 | $37.15 | $77.62 |
Sentara Setting Facility Modifier None Typical Low $39.81 Median $281.84 Typical High $2,454.71 | Facility | None | $39.81 | $281.84 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $45.71 Median $75.86 Typical High $151.36 | Professional | None | $45.71 | $75.86 | $151.36 |
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 $33.11 Median $54.95 Typical High $102.33 | Professional | None | $33.11 | $54.95 | $102.33 |
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 $22.91 Median $31.62 Typical High $34.67 | Professional | 52 · Reduced service | $22.91 | $31.62 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $12.59 Typical High $14.13 | Professional | 53 · Discontinued | $9.12 | $12.59 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $9.33 Typical High $10.47 | Professional | 55 · Aftercare only | $6.76 | $9.33 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $6.31 Typical High $7.08 | Professional | 56 · Pre-op care only | $4.57 | $6.31 | $7.08 |
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
$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.