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 $107.15 Median $4,073.80 Typical High $10,000.00 | Facility | None | $107.15 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $165.96 Typical High $812.83 | Professional | None | $100.00 | $165.96 | $812.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $83.18 Median $125.89 Typical High $181.97 | Professional | None | $83.18 | $125.89 | $181.97 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $125.89 Median $190.55 Typical High $269.15 | Professional | 50 · Both sides | $125.89 | $190.55 | $269.15 |
CareFirst Setting Professional Modifier None Typical Low $83.18 Median $93.33 Typical High $891.25 | Professional | None | $83.18 | $93.33 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,230.27 Typical High $3,019.95 | Facility | None | $512.86 | $1,230.27 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $138.04 Typical High $223.87 | Professional | None | $87.10 | $138.04 | $223.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $75.86 Median $162.18 Typical High $199.53 | Professional | None | $75.86 | $162.18 | $199.53 |
Medcost Setting Facility Modifier None Typical Low $100.00 Median $162.18 Typical High $269.15 | Facility | None | $100.00 | $162.18 | $269.15 |
Medcost Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
Sentara Setting Facility Modifier None Typical Low $89.13 Median $371.54 Typical High $2,454.71 | Facility | None | $89.13 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $144.54 Median $199.53 Typical High $1,258.93 | Professional | None | $144.54 | $199.53 | $1,258.93 |
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 $89.13 Median $154.88 Typical High $269.15 | Professional | None | $89.13 | $154.88 | $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 $50.12 Median $69.18 Typical High $87.10 | Professional | 52 · Reduced service | $50.12 | $69.18 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $27.54 Typical High $35.48 | Professional | 53 · Discontinued | $19.95 | $27.54 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $104.71 Typical High $131.83 | Professional | 54 · Surgery only | $75.86 | $104.71 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $20.89 Typical High $26.30 | Professional | 55 · Aftercare only | $15.14 | $20.89 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $13.80 Typical High $17.38 | Professional | 56 · Pre-op care only | $10.00 | $13.80 | $17.38 |
Where Virginia sits
The same service costs 3.7 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· 43rd of 51
$145
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.