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 $120.23 Median $4,365.16 Typical High $14,125.38 | Facility | None | $120.23 | $4,365.16 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $120.23 Typical High $120.23 | Professional | None | $117.49 | $120.23 | $120.23 |
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 $89.13 Median $104.71 Typical High $125.89 | Professional | None | $89.13 | $104.71 | $125.89 |
CareFirst Setting Professional Modifier None Typical Low $100.00 Median $109.65 Typical High $125.89 | Professional | None | $100.00 | $109.65 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $812.83 Typical High $3,019.95 | Facility | None | $478.63 | $812.83 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $97.72 Typical High $158.49 | Professional | None | $93.33 | $97.72 | $158.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $81.28 Median $89.13 Typical High $120.23 | Professional | None | $81.28 | $89.13 | $120.23 |
Medcost Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
Medcost Setting Facility Modifier None Typical Low $117.49 Median $147.91 Typical High $194.98 | Facility | None | $117.49 | $147.91 | $194.98 |
Medcost Setting Professional Modifier None Typical Low $93.33 Median $95.50 Typical High $147.91 | Professional | None | $93.33 | $95.50 | $147.91 |
Sentara Setting Facility Modifier None Typical Low $100.00 Median $371.54 Typical High $2,454.71 | Facility | None | $100.00 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $102.33 Median $125.89 Typical High $177.83 | Professional | None | $102.33 | $125.89 | $177.83 |
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 $83.18 Median $107.15 Typical High $177.83 | Professional | None | $83.18 | $107.15 | $177.83 |
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 $58.88 Median $58.88 Typical High $60.26 | Professional | 52 · Reduced service | $58.88 | $58.88 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | 53 · Discontinued | $23.99 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | 54 · Surgery only | $89.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $11.75 Typical High $12.02 | Professional | 56 · Pre-op care only | $11.75 | $11.75 | $12.02 |
Where Virginia sits
The same service costs 4.0 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
$110
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.