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 $33.88 Median $4,365.16 Typical High $14,125.38 | Facility | None | $33.88 | $4,365.16 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $2,570.40 | Professional | None | $23.99 | $23.99 | $2,570.40 |
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 $11.75 Median $11.75 Typical High $19.95 | Professional | None | $11.75 | $11.75 | $19.95 |
CareFirst Setting Professional Modifier None Typical Low $707.95 Median $933.25 Typical High $12,589.25 | Professional | None | $707.95 | $933.25 | $12,589.25 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $269.15 Typical High $1,659.59 | Facility | None | $138.04 | $269.15 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $50.12 Typical High $57.54 | Professional | None | $40.74 | $50.12 | $57.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $52.48 Median $63.10 Typical High $77.62 | Professional | None | $52.48 | $63.10 | $77.62 |
Medcost Setting Facility Modifier None Typical Low $23.99 Median $23.99 Typical High $36.31 | Facility | None | $23.99 | $23.99 | $36.31 |
Medcost Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
Sentara Setting Facility Modifier None Typical Low $21.88 Median $371.54 Typical High $2,454.71 | Facility | None | $21.88 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $22.39 Median $29.51 Typical High $870.96 | Professional | None | $22.39 | $29.51 | $870.96 |
United Setting Facility Modifier None Typical Low $100.00 Median $660.69 Typical High $2,041.74 | Facility | None | $100.00 | $660.69 | $2,041.74 |
United Setting Professional Modifier None Typical Low $19.05 Median $30.90 Typical High $47.86 | Professional | None | $19.05 | $30.90 | $47.86 |
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 $12.02 Median $12.02 Typical High $16.98 | Professional | 52 · Reduced service | $12.02 | $12.02 | $16.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $4.79 Typical High $6.76 | Professional | 53 · Discontinued | $4.79 | $4.79 | $6.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $18.20 Median $18.20 Typical High $25.12 | Professional | 54 · Surgery only | $18.20 | $18.20 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $3.63 Typical High $5.13 | Professional | 55 · Aftercare only | $3.63 | $3.63 | $5.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.40 Median $2.40 Typical High $3.39 | Professional | 56 · Pre-op care only | $2.40 | $2.40 | $3.39 |
Where Virginia sits
The same service costs 9.1 times more in Tennessee than in Maine. 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· 46th of 51
$47.86
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.