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 $63.10 Median $131.83 Typical High $7,079.46 | Facility | None | $63.10 | $131.83 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $89.13 Typical High $154.88 | Professional | None | $45.71 | $89.13 | $154.88 |
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 $48.98 Median $91.20 Typical High $144.54 | Professional | None | $48.98 | $91.20 | $144.54 |
CareFirst Setting Professional Modifier None Typical Low $51.29 Median $56.23 Typical High $676.08 | Professional | None | $51.29 | $56.23 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $1,230.27 | Facility | None | $50.12 | $50.12 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $89.13 Typical High $162.18 | Professional | None | $48.98 | $89.13 | $162.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $42.66 Median $123.03 Typical High $151.36 | Professional | None | $42.66 | $123.03 | $151.36 |
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 $60.26 Median $89.13 Typical High $144.54 | Facility | None | $60.26 | $89.13 | $144.54 |
Medcost Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
Sentara Setting Facility Modifier None Typical Low $53.70 Median $302.00 Typical High $2,454.71 | Facility | None | $53.70 | $302.00 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $77.62 Median $114.82 Typical High $870.96 | Professional | None | $77.62 | $114.82 | $870.96 |
United Setting Facility Modifier None Typical Low $100.00 Median $660.69 Typical High $2,089.30 | Facility | None | $100.00 | $660.69 | $2,089.30 |
United Setting Professional Modifier None Typical Low $44.67 Median $85.11 Typical High $158.49 | Professional | None | $44.67 | $85.11 | $158.49 |
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 $20.42 Median $33.88 Typical High $47.86 | Professional | 52 · Reduced service | $20.42 | $33.88 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $13.80 Typical High $19.05 | Professional | 53 · Discontinued | $8.32 | $13.80 | $19.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.90 Median $51.29 Typical High $72.44 | Professional | 54 · Surgery only | $30.90 | $51.29 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $10.23 Typical High $14.45 | Professional | 55 · Aftercare only | $6.17 | $10.23 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $6.92 Typical High $9.55 | Professional | 56 · Pre-op care only | $4.07 | $6.92 | $9.55 |
Where Virginia sits
The same service costs 3.2 times more in Alaska than in New York. 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· 37th of 51
$95.50
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.