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 $11.75 Median $11.75 Typical High $14.13 | Facility | None | $11.75 | $11.75 | $14.13 |
Aetna Setting Professional Modifier None Typical Low $11.75 Median $14.13 Typical High $14.13 | Professional | None | $11.75 | $14.13 | $14.13 |
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 $10.96 Median $13.18 Typical High $16.98 | Professional | None | $10.96 | $13.18 | $16.98 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $16.22 Median $19.50 Typical High $25.12 | Professional | 50 · Both sides | $16.22 | $19.50 | $25.12 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $6.92 Median $8.71 Typical High $13.80 | Professional | 62 · Two surgeons | $6.92 | $8.71 | $13.80 |
CareFirst Setting Professional Modifier None Typical Low $12.88 Median $14.45 Typical High $2,238.72 | Professional | None | $12.88 | $14.45 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $645.65 Typical High $1,659.59 | Facility | None | $331.13 | $645.65 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $13.80 Typical High $33.88 | Professional | None | $11.48 | $13.80 | $33.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $10.00 Median $11.75 Typical High $14.79 | Professional | None | $10.00 | $11.75 | $14.79 |
Medcost Setting Professional Modifier None Typical Low $19.05 Median $23.44 Typical High $23.44 | Professional | None | $19.05 | $23.44 | $23.44 |
Medcost Setting Facility Modifier None Typical Low $14.13 Median $19.50 Typical High $22.91 | Facility | None | $14.13 | $19.50 | $22.91 |
Medcost Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | None | $17.78 | $17.78 | $17.78 |
Sentara Setting Facility Modifier None Typical Low $12.59 Median $371.54 Typical High $2,570.40 | Facility | None | $12.59 | $371.54 | $2,570.40 |
Sentara Setting Professional Modifier None Typical Low $12.02 Median $16.98 Typical High $1,071.52 | Professional | None | $12.02 | $16.98 | $1,071.52 |
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 $10.00 Median $16.22 Typical High $25.12 | Professional | None | $10.00 | $16.22 | $25.12 |
4 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 $5.89 Median $7.08 Typical High $7.08 | Professional | 52 · Reduced service | $5.89 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.34 Median $2.82 Typical High $2.82 | Professional | 53 · Discontinued | $2.34 | $2.82 | $2.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.78 Median $2.14 Typical High $2.14 | Professional | 55 · Aftercare only | $1.78 | $2.14 | $2.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.17 Median $1.41 Typical High $1.41 | Professional | 56 · Pre-op care only | $1.17 | $1.41 | $1.41 |
Where Virginia sits
The same service costs 12.3 times more in Florida than in Kentucky. 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· 47th of 51
$14.13
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.