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 $131.83 Median $4,786.30 Typical High $14,125.38 | Facility | None | $131.83 | $4,786.30 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $131.83 Typical High $131.83 | Professional | None | $123.03 | $131.83 | $131.83 |
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 $97.72 Median $114.82 Typical High $138.04 | Professional | None | $97.72 | $114.82 | $138.04 |
CareFirst Setting Professional Modifier None Typical Low $97.72 Median $109.65 Typical High $125.89 | Professional | None | $97.72 | $109.65 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $478.63 Typical High $2,691.53 | Facility | None | $245.47 | $478.63 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $109.65 Typical High $154.88 | Professional | None | $97.72 | $109.65 | $154.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $87.10 Median $95.50 Typical High $154.88 | Professional | None | $87.10 | $95.50 | $154.88 |
Medcost Setting Professional Modifier None Typical Low $131.83 Median $169.82 Typical High $169.82 | Professional | None | $131.83 | $169.82 | $169.82 |
Medcost Setting Facility Modifier None Typical Low $123.03 Median $134.90 Typical High $204.17 | Facility | None | $123.03 | $134.90 | $204.17 |
Medcost Setting Professional Modifier None Typical Low $85.11 Median $100.00 Typical High $162.18 | Professional | None | $85.11 | $100.00 | $162.18 |
Sentara Setting Facility Modifier None Typical Low $95.50 Median $371.54 Typical High $2,570.40 | Facility | None | $95.50 | $371.54 | $2,570.40 |
Sentara Setting Professional Modifier None Typical Low $89.13 Median $114.82 Typical High $173.78 | Professional | None | $89.13 | $114.82 | $173.78 |
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 $81.28 Median $102.33 Typical High $173.78 | Professional | None | $81.28 | $102.33 | $173.78 |
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 $61.66 Median $64.57 Typical High $66.07 | Professional | 52 · Reduced service | $61.66 | $64.57 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $25.70 Typical High $26.30 | Professional | 53 · Discontinued | $24.55 | $25.70 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $95.50 Typical High $97.72 | Professional | 54 · Surgery only | $93.33 | $95.50 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $19.05 Typical High $19.50 | Professional | 55 · Aftercare only | $18.62 | $19.05 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.88 Typical High $13.18 | Professional | 56 · Pre-op care only | $12.30 | $12.88 | $13.18 |
Where Virginia sits
The same service costs 4.8 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· 40th of 51
$112
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.