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 $213.80 Median $4,073.80 Typical High $10,000.00 | Facility | None | $213.80 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $165.96 Typical High $275.42 | Professional | None | $91.20 | $165.96 | $275.42 |
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 $77.62 Median $177.83 Typical High $269.15 | Professional | None | $77.62 | $177.83 | $269.15 |
CareFirst Setting Professional Modifier None Typical Low $79.43 Median $89.13 Typical High $104.71 | Professional | None | $79.43 | $89.13 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $630.96 Typical High $1,621.81 | Facility | None | $346.74 | $630.96 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $177.83 Typical High $257.04 | Professional | None | $81.28 | $177.83 | $257.04 |
Kaiser Permanente Setting Professional Modifier None Typical Low $234.42 Median $281.84 Typical High $346.74 | Professional | None | $234.42 | $281.84 | $346.74 |
Medcost Setting Professional Modifier None Typical Low $257.04 Median $316.23 Typical High $316.23 | Professional | None | $257.04 | $316.23 | $316.23 |
Medcost Setting Facility Modifier None Typical Low $91.20 Median $147.91 Typical High $346.74 | Facility | None | $91.20 | $147.91 | $346.74 |
Medcost Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $263.03 | Professional | None | $144.54 | $144.54 | $263.03 |
Sentara Setting Facility Modifier None Typical Low $85.11 Median $912.01 Typical High $3,630.78 | Facility | None | $85.11 | $912.01 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $151.36 Median $208.93 Typical High $354.81 | Professional | None | $151.36 | $208.93 | $354.81 |
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 $66.07 Median $138.04 Typical High $281.84 | Professional | None | $66.07 | $138.04 | $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 $45.71 Median $67.61 Typical High $138.04 | Professional | 52 · Reduced service | $45.71 | $67.61 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $26.92 Typical High $54.95 | Professional | 53 · Discontinued | $18.20 | $26.92 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $100.00 Typical High $208.93 | Professional | 54 · Surgery only | $67.61 | $100.00 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $19.95 Typical High $41.69 | Professional | 55 · Aftercare only | $13.80 | $19.95 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $13.49 Typical High $27.54 | Professional | 56 · Pre-op care only | $9.12 | $13.49 | $27.54 |
Where Virginia sits
The same service costs 4.1 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· 40th of 51
$162
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.