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 $61.66 Median $223.87 Typical High $8,317.64 | Facility | None | $61.66 | $223.87 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $93.33 Typical High $131.83 | Professional | None | $45.71 | $93.33 | $131.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,737.80 Median $2,398.83 Typical High $2,951.21 | Facility | None | $1,737.80 | $2,398.83 | $2,951.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $41.69 Median $74.13 Typical High $107.15 | Professional | None | $41.69 | $74.13 | $107.15 |
CareFirst Setting Professional Modifier None Typical Low $42.66 Median $46.77 Typical High $57.54 | Professional | None | $42.66 | $46.77 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $89.13 Typical High $141.25 | Professional | None | $43.65 | $89.13 | $141.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $89.13 Median $104.71 Typical High $144.54 | Professional | None | $89.13 | $104.71 | $144.54 |
Medcost Setting Professional Modifier None Typical Low $190.55 Median $234.42 Typical High $234.42 | Professional | None | $190.55 | $234.42 | $234.42 |
Medcost Setting Facility Modifier None Typical Low $81.28 Median $123.03 Typical High $169.82 | Facility | None | $81.28 | $123.03 | $169.82 |
Medcost Setting Professional Modifier None Typical Low $79.43 Median $95.50 Typical High $208.93 | Professional | None | $79.43 | $95.50 | $208.93 |
Sentara Setting Facility Modifier None Typical Low $45.71 Median $102.33 Typical High $10,232.93 | Facility | None | $45.71 | $102.33 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $91.20 Median $128.82 Typical High $181.97 | Professional | None | $91.20 | $128.82 | $181.97 |
United Setting Facility Modifier None Typical Low $204.17 Median $1,047.13 Typical High $2,454.71 | Facility | None | $204.17 | $1,047.13 | $2,454.71 |
United Setting Professional Modifier None Typical Low $38.02 Median $81.28 Typical High $169.82 | Professional | None | $38.02 | $81.28 | $169.82 |
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 $22.91 Median $40.74 Typical High $48.98 | Professional | 52 · Reduced service | $22.91 | $40.74 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $16.60 Typical High $19.50 | Professional | 53 · Discontinued | $9.12 | $16.60 | $19.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $61.66 Typical High $74.13 | Professional | 54 · Surgery only | $34.67 | $61.66 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $12.30 Typical High $14.79 | Professional | 55 · Aftercare only | $6.92 | $12.30 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $8.13 Typical High $9.77 | Professional | 56 · Pre-op care only | $4.57 | $8.13 | $9.77 |
Where Virginia sits
The same service costs 2.5 times more in North Carolina 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· 44th of 51
$83.18
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.