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 $91.20 Median $4,073.80 Typical High $10,000.00 | Facility | None | $91.20 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $107.15 Typical High $125.89 | Professional | None | $91.20 | $107.15 | $125.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $75.86 Median $102.33 Typical High $141.25 | Professional | None | $75.86 | $102.33 | $141.25 |
CareFirst Setting Professional Modifier None Typical Low $77.62 Median $87.10 Typical High $114.82 | Professional | None | $77.62 | $87.10 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $109.65 Typical High $165.96 | Professional | None | $81.28 | $109.65 | $165.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $107.15 Median $125.89 Typical High $154.88 | Professional | None | $107.15 | $125.89 | $154.88 |
Medcost Setting Professional Modifier None Typical Low $123.03 Median $154.88 Typical High $154.88 | Professional | None | $123.03 | $154.88 | $154.88 |
Medcost Setting Facility Modifier None Typical Low $120.23 Median $144.54 Typical High $181.97 | Facility | None | $120.23 | $144.54 | $181.97 |
Medcost Setting Professional Modifier None Typical Low $100.00 Median $131.83 Typical High $131.83 | Professional | None | $100.00 | $131.83 | $131.83 |
Sentara Setting Facility Modifier None Typical Low $64.57 Median $128.82 Typical High $10,232.93 | Facility | None | $64.57 | $128.82 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $85.11 Median $123.03 Typical High $263.03 | Professional | None | $85.11 | $123.03 | $263.03 |
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 $70.79 Median $107.15 Typical High $181.97 | Professional | None | $70.79 | $107.15 | $181.97 |
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 $44.67 Median $51.29 Typical High $63.10 | Professional | 52 · Reduced service | $44.67 | $51.29 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $20.42 Typical High $25.12 | Professional | 53 · Discontinued | $18.20 | $20.42 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $75.86 Typical High $93.33 | Professional | 54 · Surgery only | $67.61 | $75.86 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $15.14 Typical High $18.62 | Professional | 55 · Aftercare only | $13.49 | $15.14 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $10.23 Typical High $12.59 | Professional | 56 · Pre-op care only | $9.12 | $10.23 | $12.59 |
Where Virginia sits
The same service costs 3.8 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
$105
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.