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 $208.93 Median $4,365.16 Typical High $14,125.38 | Facility | None | $208.93 | $4,365.16 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $208.93 Typical High $208.93 | Professional | None | $194.98 | $208.93 | $208.93 |
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 $154.88 Median $181.97 Typical High $223.87 | Professional | None | $154.88 | $181.97 | $223.87 |
CareFirst Setting Professional Modifier None Typical Low $173.78 Median $194.98 Typical High $223.87 | Professional | None | $173.78 | $194.98 | $223.87 |
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 $131.83 Median $169.82 Typical High $245.47 | Professional | None | $131.83 | $169.82 | $245.47 |
Kaiser Permanente Setting Professional Modifier None Typical Low $141.25 Median $154.88 Typical High $234.42 | Professional | None | $141.25 | $154.88 | $234.42 |
Medcost Setting Professional Modifier None Typical Low $162.18 Median $204.17 Typical High $204.17 | Professional | None | $162.18 | $204.17 | $204.17 |
Medcost Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $316.23 | Facility | None | $165.96 | $165.96 | $316.23 |
Medcost Setting Professional Modifier None Typical Low $151.36 Median $173.78 Typical High $251.19 | Professional | None | $151.36 | $173.78 | $251.19 |
Sentara Setting Facility Modifier None Typical Low $114.82 Median $398.11 Typical High $2,454.71 | Facility | None | $114.82 | $398.11 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $109.65 Median $147.91 Typical High $257.04 | Professional | None | $109.65 | $147.91 | $257.04 |
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 $107.15 Median $147.91 Typical High $269.15 | Professional | None | $107.15 | $147.91 | $269.15 |
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 $97.72 Median $102.33 Typical High $104.71 | Professional | 52 · Reduced service | $97.72 | $102.33 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $40.74 Typical High $41.69 | Professional | 53 · Discontinued | $38.90 | $40.74 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $151.36 Typical High $154.88 | Professional | 54 · Surgery only | $144.54 | $151.36 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $30.20 Typical High $30.90 | Professional | 55 · Aftercare only | $28.84 | $30.20 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $20.42 Typical High $20.89 | Professional | 56 · Pre-op care only | $19.50 | $20.42 | $20.89 |
Where Virginia sits
The same service costs 4.6 times more in Alaska than in Utah. 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· 37th of 51
$178
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.