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 $112.20 Median $3,801.89 Typical High $9,332.54 | Facility | None | $112.20 | $3,801.89 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $109.65 Typical High $141.25 | Professional | None | $74.13 | $109.65 | $141.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $67.61 Median $102.33 Typical High $154.88 | Professional | None | $67.61 | $102.33 | $154.88 |
CareFirst Setting Professional Modifier None Typical Low $69.18 Median $75.86 Typical High $100.00 | Professional | None | $69.18 | $75.86 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $114.82 Typical High $177.83 | Professional | None | $70.79 | $114.82 | $177.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $114.82 Median $131.83 Typical High $169.82 | Professional | None | $114.82 | $131.83 | $169.82 |
Medcost Setting Professional Modifier None Typical Low $144.54 Median $181.97 Typical High $891.25 | Professional | None | $144.54 | $181.97 | $891.25 |
Medcost Setting Facility Modifier None Typical Low $104.71 Median $128.82 Typical High $181.97 | Facility | None | $104.71 | $128.82 | $181.97 |
Medcost Setting Professional Modifier None Typical Low $57.54 Median $112.20 Typical High $131.83 | Professional | None | $57.54 | $112.20 | $131.83 |
Sentara Setting Facility Modifier None Typical Low $54.95 Median $134.90 Typical High $10,232.93 | Facility | None | $54.95 | $134.90 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $109.65 Median $154.88 Typical High $512.86 | Professional | None | $109.65 | $154.88 | $512.86 |
United Setting Facility Modifier None Typical Low $204.17 Median $1,023.29 Typical High $2,398.83 | Facility | None | $204.17 | $1,023.29 | $2,398.83 |
United Setting Professional Modifier None Typical Low $66.07 Median $109.65 Typical High $204.17 | Professional | None | $66.07 | $109.65 | $204.17 |
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 $37.15 Median $46.77 Typical High $67.61 | Professional | 52 · Reduced service | $37.15 | $46.77 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $18.62 Typical High $26.92 | Professional | 53 · Discontinued | $14.79 | $18.62 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $69.18 Typical High $100.00 | Professional | 54 · Surgery only | $56.23 | $69.18 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $13.80 Typical High $19.95 | Professional | 55 · Aftercare only | $11.22 | $13.80 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $9.33 Typical High $13.49 | Professional | 56 · Pre-op care only | $7.41 | $9.33 | $13.49 |
Where Virginia sits
The same service costs 3.2 times more in Alaska than in Florida. 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
$110
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.