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 $123.03 Median $5,495.41 Typical High $14,125.38 | Facility | None | $123.03 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $123.03 | Professional | None | $120.23 | $120.23 | $123.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $95.50 Median $281.84 Typical High $524.81 | Facility | None | $95.50 | $281.84 | $524.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $97.72 Median $117.49 Typical High $138.04 | Professional | None | $97.72 | $117.49 | $138.04 |
CareFirst Setting Professional Modifier None Typical Low $107.15 Median $120.23 Typical High $138.04 | Professional | None | $107.15 | $120.23 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $794.33 Typical High $5,495.41 | Facility | None | $501.19 | $794.33 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $109.65 Typical High $158.49 | Professional | None | $100.00 | $109.65 | $158.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $89.13 Median $102.33 Typical High $173.78 | Professional | None | $89.13 | $102.33 | $173.78 |
Medcost Setting Professional Modifier None Typical Low $141.25 Median $177.83 Typical High $177.83 | Professional | None | $141.25 | $177.83 | $177.83 |
Medcost Setting Facility Modifier None Typical Low $120.23 Median $144.54 Typical High $199.53 | Facility | None | $120.23 | $144.54 | $199.53 |
Medcost Setting Professional Modifier None Typical Low $128.82 Median $138.04 Typical High $186.21 | Professional | None | $128.82 | $138.04 | $186.21 |
Sentara Setting Facility Modifier None Typical Low $100.00 Median $549.54 Typical High $5,128.61 | Facility | None | $100.00 | $549.54 | $5,128.61 |
Sentara Setting Professional Modifier None Typical Low $104.71 Median $123.03 Typical High $181.97 | Professional | None | $104.71 | $123.03 | $181.97 |
United Setting Facility Modifier None Typical Low $436.52 Median $2,344.23 Typical High $6,309.57 | Facility | None | $436.52 | $2,344.23 | $6,309.57 |
United Setting Professional Modifier None Typical Low $83.18 Median $102.33 Typical High $177.83 | Professional | None | $83.18 | $102.33 | $177.83 |
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 $60.26 Median $60.26 Typical High $61.66 | Professional | 52 · Reduced service | $60.26 | $60.26 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $24.55 | Professional | 53 · Discontinued | $23.99 | $23.99 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $89.13 Typical High $91.20 | Professional | 54 · Surgery only | $89.13 | $89.13 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $18.20 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $12.30 | Professional | 56 · Pre-op care only | $12.02 | $12.02 | $12.30 |
Where Virginia sits
The same service costs 4.4 times more in Alaska than in New Jersey. 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
$117
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.