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 $61.66 Median $4,073.80 Typical High $10,000.00 | Facility | None | $61.66 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $61.66 Typical High $61.66 | Professional | None | $57.54 | $61.66 | $61.66 |
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 $45.71 Median $54.95 Typical High $64.57 | Professional | None | $45.71 | $54.95 | $64.57 |
CareFirst Setting Professional Modifier None Typical Low $51.29 Median $57.54 Typical High $66.07 | Professional | None | $51.29 | $57.54 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $407.38 Typical High $1,621.81 | Facility | None | $245.47 | $407.38 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $50.12 Typical High $77.62 | Professional | None | $47.86 | $50.12 | $77.62 |
Kaiser Permanente Setting Professional Modifier None Typical Low $41.69 Median $45.71 Typical High $77.62 | Professional | None | $41.69 | $45.71 | $77.62 |
Medcost Setting Professional Modifier None Typical Low $74.13 Median $93.33 Typical High $93.33 | Professional | None | $74.13 | $93.33 | $93.33 |
Medcost Setting Facility Modifier None Typical Low $57.54 Median $72.44 Typical High $93.33 | Facility | None | $57.54 | $72.44 | $93.33 |
Medcost Setting Professional Modifier None Typical Low $64.57 Median $66.07 Typical High $117.49 | Professional | None | $64.57 | $66.07 | $117.49 |
Sentara Setting Facility Modifier None Typical Low $48.98 Median $371.54 Typical High $2,454.71 | Facility | None | $48.98 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $48.98 Median $63.10 Typical High $95.50 | Professional | None | $48.98 | $63.10 | $95.50 |
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 $40.74 Median $50.12 Typical High $89.13 | Professional | None | $40.74 | $50.12 | $89.13 |
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 $28.84 Median $30.20 Typical High $30.90 | Professional | 52 · Reduced service | $28.84 | $30.20 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $12.02 Typical High $12.30 | Professional | 53 · Discontinued | $11.48 | $12.02 | $12.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $45.71 Typical High $45.71 | Professional | 54 · Surgery only | $42.66 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $9.12 Typical High $9.33 | Professional | 55 · Aftercare only | $8.71 | $9.12 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $6.03 Typical High $6.17 | Professional | 56 · Pre-op care only | $5.75 | $6.03 | $6.17 |
Where Virginia sits
The same service costs 4.2 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· 42nd of 51
$56.23
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.