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 $134.90 Median $4,365.16 Typical High $10,000.00 | Facility | None | $134.90 | $4,365.16 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $134.90 Typical High $134.90 | Professional | None | $131.83 | $134.90 | $134.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,000.00 Median $6,760.83 Typical High $9,549.93 | Facility | None | $1,000.00 | $6,760.83 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $109.65 Median $128.82 Typical High $154.88 | Professional | None | $109.65 | $128.82 | $154.88 |
CareFirst Setting Professional Modifier None Typical Low $109.65 Median $120.23 Typical High $141.25 | Professional | None | $109.65 | $120.23 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $3,548.13 Typical High $8,317.64 | Facility | None | $346.74 | $3,548.13 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $123.03 Typical High $181.97 | Professional | None | $112.20 | $123.03 | $181.97 |
Kaiser Permanente Setting Professional Modifier None Typical Low $104.71 Median $120.23 Typical High $204.17 | Professional | None | $104.71 | $120.23 | $204.17 |
Medcost Setting Professional Modifier None Typical Low $128.82 Median $162.18 Typical High $162.18 | Professional | None | $128.82 | $162.18 | $162.18 |
Medcost Setting Facility Modifier None Typical Low $131.83 Median $162.18 Typical High $213.80 | Facility | None | $131.83 | $162.18 | $213.80 |
Medcost Setting Professional Modifier None Typical Low $109.65 Median $112.20 Typical High $154.88 | Professional | None | $109.65 | $112.20 | $154.88 |
Sentara Setting Facility Modifier None Typical Low $93.33 Median $933.25 Typical High $10,232.93 | Facility | None | $93.33 | $933.25 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $100.00 Median $131.83 Typical High $199.53 | Professional | None | $100.00 | $131.83 | $199.53 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $6,760.83 Typical High $17,378.01 | Facility | None | $1,548.82 | $6,760.83 | $17,378.01 |
United Setting Professional Modifier None Typical Low $91.20 Median $112.20 Typical High $194.98 | Professional | None | $91.20 | $112.20 | $194.98 |
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 $66.07 Median $66.07 Typical High $67.61 | Professional | 52 · Reduced service | $66.07 | $66.07 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $26.30 Typical High $26.92 | Professional | 53 · Discontinued | $26.30 | $26.30 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $97.72 Typical High $102.33 | Professional | 54 · Surgery only | $97.72 | $97.72 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $19.95 Typical High $20.42 | Professional | 55 · Aftercare only | $19.95 | $19.95 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.18 Typical High $13.49 | Professional | 56 · Pre-op care only | $13.18 | $13.18 | $13.49 |
Where Virginia sits
The same service costs 4.8 times more in Alaska than in Utah. 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· 37th of 51
$126
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.