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 $208.93 Median $4,073.80 Typical High $10,000.00 | Facility | None | $208.93 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $177.83 Typical High $234.42 | Professional | None | $93.33 | $177.83 | $234.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,000.00 Median $2,187.76 Typical High $2,951.21 | Facility | None | $1,000.00 | $2,187.76 | $2,951.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $77.62 Median $151.36 Typical High $229.09 | Professional | None | $77.62 | $151.36 | $229.09 |
CareFirst Setting Professional Modifier None Typical Low $79.43 Median $87.10 Typical High $102.33 | Professional | None | $79.43 | $87.10 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $316.23 Typical High $2,570.40 | Facility | None | $141.25 | $316.23 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $173.78 Typical High $257.04 | Professional | None | $81.28 | $173.78 | $257.04 |
Kaiser Permanente Setting Professional Modifier None Typical Low $190.55 Median $223.87 Typical High $316.23 | Professional | None | $190.55 | $223.87 | $316.23 |
Medcost Setting Professional Modifier None Typical Low $275.42 Median $467.74 Typical High $467.74 | Professional | None | $275.42 | $467.74 | $467.74 |
Medcost Setting Facility Modifier None Typical Low $93.33 Median $154.88 Typical High $338.84 | Facility | None | $93.33 | $154.88 | $338.84 |
Medcost Setting Professional Modifier None Typical Low $162.18 Median $234.42 Typical High $245.47 | Professional | None | $162.18 | $234.42 | $245.47 |
Sentara Setting Facility Modifier None Typical Low $81.28 Median $912.01 Typical High $3,630.78 | Facility | None | $81.28 | $912.01 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $194.98 Median $213.80 Typical High $316.23 | Professional | None | $194.98 | $213.80 | $316.23 |
United Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $5,888.44 | Facility | None | $588.84 | $2,187.76 | $5,888.44 |
United Setting Professional Modifier None Typical Low $69.18 Median $151.36 Typical High $281.84 | Professional | None | $69.18 | $151.36 | $281.84 |
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 $46.77 Median $79.43 Typical High $117.49 | Professional | 52 · Reduced service | $46.77 | $79.43 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $31.62 Typical High $46.77 | Professional | 53 · Discontinued | $18.62 | $31.62 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $117.49 Typical High $173.78 | Professional | 54 · Surgery only | $70.79 | $117.49 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $23.44 Typical High $35.48 | Professional | 55 · Aftercare only | $14.13 | $23.44 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $15.85 Typical High $23.44 | Professional | 56 · Pre-op care only | $9.33 | $15.85 | $23.44 |
Where Virginia sits
The same service costs 3.7 times more in Alaska than in Maryland. 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
$158
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.