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 $104.71 Median $4,365.16 Typical High $14,125.38 | Facility | None | $104.71 | $4,365.16 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $123.03 Typical High $151.36 | Professional | None | $102.33 | $123.03 | $151.36 |
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 $87.10 Median $120.23 Typical High $165.96 | Professional | None | $87.10 | $120.23 | $165.96 |
CareFirst Setting Professional Modifier None Typical Low $85.11 Median $95.50 Typical High $691.83 | Professional | None | $85.11 | $95.50 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $478.63 Typical High $1,621.81 | Facility | None | $331.13 | $478.63 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $128.82 Typical High $213.80 | Professional | None | $87.10 | $128.82 | $213.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $81.28 Median $158.49 Typical High $194.98 | Professional | None | $81.28 | $158.49 | $194.98 |
Medcost Setting Professional Modifier None Typical Low $186.21 Median $229.09 Typical High $229.09 | Professional | None | $186.21 | $229.09 | $229.09 |
Medcost Setting Facility Modifier None Typical Low $102.33 Median $141.25 Typical High $229.09 | Facility | None | $102.33 | $141.25 | $229.09 |
Medcost Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
Sentara Setting Facility Modifier None Typical Low $93.33 Median $616.60 Typical High $2,951.21 | Facility | None | $93.33 | $616.60 | $2,951.21 |
Sentara Setting Professional Modifier None Typical Low $131.83 Median $173.78 Typical High $1,737.80 | Professional | None | $131.83 | $173.78 | $1,737.80 |
United Setting Facility Modifier None Typical Low $323.59 Median $1,412.54 Typical High $3,630.78 | Facility | None | $323.59 | $1,412.54 | $3,630.78 |
United Setting Professional Modifier None Typical Low $81.28 Median $144.54 Typical High $234.42 | Professional | None | $81.28 | $144.54 | $234.42 |
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 $51.29 Median $58.88 Typical High $75.86 | Professional | 52 · Reduced service | $51.29 | $58.88 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $23.99 Typical High $30.20 | Professional | 53 · Discontinued | $20.89 | $23.99 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $89.13 Typical High $112.20 | Professional | 54 · Surgery only | $77.62 | $89.13 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $17.78 Typical High $22.91 | Professional | 55 · Aftercare only | $15.49 | $17.78 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $11.75 Typical High $15.14 | Professional | 56 · Pre-op care only | $10.23 | $11.75 | $15.14 |
Where Virginia sits
The same service costs 3.5 times more in Alaska than in Indiana. 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
$135
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.