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 $79.43 Median $194.98 Typical High $7,079.46 | Facility | None | $79.43 | $194.98 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $141.25 Typical High $223.87 | Professional | None | $63.10 | $141.25 | $223.87 |
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 $52.48 Median $63.10 Typical High $79.43 | Professional | None | $52.48 | $63.10 | $79.43 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $79.43 Median $95.50 Typical High $120.23 | Professional | 50 · Both sides | $79.43 | $95.50 | $120.23 |
CareFirst Setting Professional Modifier None Typical Low $53.70 Median $60.26 Typical High $691.83 | Professional | None | $53.70 | $60.26 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $1,230.27 | Facility | None | $50.12 | $50.12 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $114.82 Typical High $229.09 | Professional | None | $56.23 | $114.82 | $229.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $131.83 Median $199.53 Typical High $239.88 | Professional | None | $131.83 | $199.53 | $239.88 |
Medcost Setting Professional Modifier None Typical Low $131.83 Median $162.18 Typical High $162.18 | Professional | None | $131.83 | $162.18 | $162.18 |
Medcost Setting Facility Modifier None Typical Low $63.10 Median $104.71 Typical High $251.19 | Facility | None | $63.10 | $104.71 | $251.19 |
Medcost Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Sentara Setting Facility Modifier None Typical Low $58.88 Median $223.87 Typical High $2,454.71 | Facility | None | $58.88 | $223.87 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $104.71 Median $177.83 Typical High $870.96 | Professional | None | $104.71 | $177.83 | $870.96 |
United Setting Facility Modifier None Typical Low $100.00 Median $645.65 Typical High $2,041.74 | Facility | None | $100.00 | $645.65 | $2,041.74 |
United Setting Professional Modifier None Typical Low $48.98 Median $104.71 Typical High $229.09 | Professional | None | $48.98 | $104.71 | $229.09 |
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 $31.62 Median $39.81 Typical High $97.72 | Professional | 52 · Reduced service | $31.62 | $39.81 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $15.85 Typical High $39.81 | Professional | 53 · Discontinued | $12.59 | $15.85 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $58.88 Typical High $147.91 | Professional | 54 · Surgery only | $47.86 | $58.88 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $11.75 Typical High $29.51 | Professional | 55 · Aftercare only | $9.55 | $11.75 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $7.94 Typical High $19.50 | Professional | 56 · Pre-op care only | $6.31 | $7.94 | $19.50 |
Where Virginia sits
The same service costs 4.0 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
$85.11
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.