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 $10.00 Median $13.80 Typical High $38.02 | Facility | None | $10.00 | $13.80 | $38.02 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $13.80 Typical High $16.98 | Professional | None | $10.00 | $13.80 | $16.98 |
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 $11.48 Median $14.79 Typical High $19.95 | Professional | None | $11.48 | $14.79 | $19.95 |
CareFirst Setting Professional Modifier None Typical Low $12.02 Median $14.45 Typical High $20.42 | Professional | None | $12.02 | $14.45 | $20.42 |
Cigna Setting Facility Modifier None Typical Low $6.03 Median $16.60 Typical High $1,621.81 | Facility | None | $6.03 | $16.60 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $15.85 Typical High $33.88 | Professional | None | $11.48 | $15.85 | $33.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $10.00 Median $16.98 Typical High $20.89 | Professional | None | $10.00 | $16.98 | $20.89 |
Medcost Setting Professional Modifier None Typical Low $37.15 Median $46.77 Typical High $46.77 | Professional | None | $37.15 | $46.77 | $46.77 |
Medcost Setting Facility Modifier None Typical Low $13.80 Median $17.38 Typical High $27.54 | Facility | None | $13.80 | $17.38 | $27.54 |
Medcost Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | None | $22.91 | $22.91 | $22.91 |
Sentara Setting Facility Modifier None Typical Low $12.30 Median $257.04 Typical High $2,454.71 | Facility | None | $12.30 | $257.04 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $16.60 Median $22.39 Typical High $870.96 | Professional | None | $16.60 | $22.39 | $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 $11.22 Median $18.62 Typical High $32.36 | Professional | None | $11.22 | $18.62 | $32.36 |
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 $5.01 Median $6.92 Typical High $8.51 | Professional | 52 · Reduced service | $5.01 | $6.92 | $8.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.00 Median $2.75 Typical High $3.39 | Professional | 53 · Discontinued | $2.00 | $2.75 | $3.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $7.41 Median $10.23 Typical High $12.59 | Professional | 54 · Surgery only | $7.41 | $10.23 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.48 Median $2.04 Typical High $2.51 | Professional | 55 · Aftercare only | $1.48 | $2.04 | $2.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.00 Median $1.38 Typical High $1.70 | Professional | 56 · Pre-op care only | $1.00 | $1.38 | $1.70 |
Where Virginia sits
The same service costs 3.5 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· 46th of 51
$15.85
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.