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 $56.23 Median $3,801.89 Typical High $10,000.00 | Facility | None | $56.23 | $3,801.89 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $112.20 Typical High $158.49 | Professional | None | $54.95 | $112.20 | $158.49 |
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 $45.71 Median $87.10 Typical High $154.88 | Professional | None | $45.71 | $87.10 | $154.88 |
CareFirst Setting Professional Modifier None Typical Low $50.12 Median $56.23 Typical High $64.57 | Professional | None | $50.12 | $56.23 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $316.23 Typical High $1,621.81 | Facility | None | $120.23 | $316.23 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $102.33 Typical High $151.36 | Professional | None | $46.77 | $102.33 | $151.36 |
Kaiser Permanente Setting Professional Modifier None Typical Low $144.54 Median $169.82 Typical High $213.80 | Professional | None | $144.54 | $169.82 | $213.80 |
Medcost Setting Professional Modifier None Typical Low $89.13 Median $123.03 Typical High $123.03 | Professional | None | $89.13 | $123.03 | $123.03 |
Medcost Setting Facility Modifier None Typical Low $54.95 Median $89.13 Typical High $223.87 | Facility | None | $54.95 | $89.13 | $223.87 |
Medcost Setting Professional Modifier None Typical Low $56.23 Median $64.57 Typical High $134.90 | Professional | None | $56.23 | $64.57 | $134.90 |
Sentara Setting Facility Modifier None Typical Low $33.88 Median $616.60 Typical High $2,951.21 | Facility | None | $33.88 | $616.60 | $2,951.21 |
Sentara Setting Professional Modifier None Typical Low $66.07 Median $134.90 Typical High $208.93 | Professional | None | $66.07 | $134.90 | $208.93 |
United Setting Facility Modifier None Typical Low $323.59 Median $1,445.44 Typical High $3,630.78 | Facility | None | $323.59 | $1,445.44 | $3,630.78 |
United Setting Professional Modifier None Typical Low $37.15 Median $81.28 Typical High $158.49 | Professional | None | $37.15 | $81.28 | $158.49 |
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 $27.54 Median $42.66 Typical High $79.43 | Professional | 52 · Reduced service | $27.54 | $42.66 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $16.98 Typical High $31.62 | Professional | 53 · Discontinued | $10.96 | $16.98 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $64.57 Typical High $117.49 | Professional | 54 · Surgery only | $41.69 | $64.57 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $12.88 Typical High $23.44 | Professional | 55 · Aftercare only | $8.32 | $12.88 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $8.51 Typical High $15.85 | Professional | 56 · Pre-op care only | $5.50 | $8.51 | $15.85 |
Where Virginia sits
The same service costs 3.5 times more in Alaska than in Washington, DC. 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
$89.13
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.