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 $165.96 Median $4,073.80 Typical High $10,000.00 | Facility | None | $165.96 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $354.81 Typical High $831.76 | Professional | None | $154.88 | $354.81 | $831.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $131.83 Median $245.47 Typical High $389.05 | Professional | None | $131.83 | $245.47 | $389.05 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $194.98 Median $363.08 Typical High $575.44 | Professional | 50 · Both sides | $194.98 | $363.08 | $575.44 |
CareFirst Setting Professional Modifier None Typical Low $128.82 Median $141.25 Typical High $912.01 | Professional | None | $128.82 | $141.25 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,348.96 Typical High $3,019.95 | Facility | None | $630.96 | $1,348.96 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $288.40 Typical High $562.34 | Professional | None | $131.83 | $288.40 | $562.34 |
Kaiser Permanente Setting Professional Modifier None Typical Low $114.82 Median $363.08 Typical High $446.68 | Professional | None | $114.82 | $363.08 | $446.68 |
Medcost Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $676.08 | Professional | None | $537.03 | $676.08 | $676.08 |
Medcost Setting Facility Modifier None Typical Low $154.88 Median $251.19 Typical High $575.44 | Facility | None | $154.88 | $251.19 | $575.44 |
Medcost Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
Sentara Setting Facility Modifier None Typical Low $141.25 Median $371.54 Typical High $2,454.71 | Facility | None | $141.25 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $331.13 Median $489.78 Typical High $1,479.11 | Professional | None | $331.13 | $489.78 | $1,479.11 |
United Setting Facility Modifier None Typical Low $100.00 Median $660.69 Typical High $2,089.30 | Facility | None | $100.00 | $660.69 | $2,089.30 |
United Setting Professional Modifier None Typical Low $144.54 Median $309.03 Typical High $630.96 | Professional | None | $144.54 | $309.03 | $630.96 |
3 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 54 · Surgery only Typical Low $114.82 Median $169.82 Typical High $295.12 | Professional | 54 · Surgery only | $114.82 | $169.82 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $33.88 Typical High $58.88 | Professional | 55 · Aftercare only | $22.91 | $33.88 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $22.91 Typical High $39.81 | Professional | 56 · Pre-op care only | $15.49 | $22.91 | $39.81 |
Where Virginia sits
The same service costs 3.4 times more in Alaska than in Nebraska. 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· 44th of 51
$302
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.