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 $346.74 Median $4,073.80 Typical High $10,000.00 | Facility | None | $346.74 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $363.08 Typical High $446.68 | Professional | None | $302.00 | $363.08 | $446.68 |
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 $288.40 Median $346.74 Typical High $446.68 | Professional | None | $288.40 | $346.74 | $446.68 |
CareFirst Setting Professional Modifier None Typical Low $302.00 Median $331.13 Typical High $1,513.56 | Professional | None | $302.00 | $331.13 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $323.59 Typical High $1,621.81 | Facility | None | $169.82 | $323.59 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $398.11 Typical High $616.60 | Professional | None | $302.00 | $398.11 | $616.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $257.04 Median $457.09 Typical High $575.44 | Professional | None | $257.04 | $457.09 | $575.44 |
Medcost Setting Professional Modifier None Typical Low $524.81 Median $645.65 Typical High $645.65 | Professional | None | $524.81 | $645.65 | $645.65 |
Medcost Setting Facility Modifier None Typical Low $346.74 Median $446.68 Typical High $741.31 | Facility | None | $346.74 | $446.68 | $741.31 |
Medcost Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
Sentara Setting Facility Modifier None Typical Low $288.40 Median $489.78 Typical High $2,454.71 | Facility | None | $288.40 | $489.78 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $380.19 Median $524.81 Typical High $1,230.27 | Professional | None | $380.19 | $524.81 | $1,230.27 |
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 $263.03 Median $457.09 Typical High $724.44 | Professional | None | $263.03 | $457.09 | $724.44 |
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 $151.36 Median $173.78 Typical High $223.87 | Professional | 52 · Reduced service | $151.36 | $173.78 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $69.18 Typical High $89.13 | Professional | 53 · Discontinued | $60.26 | $69.18 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $263.03 Typical High $338.84 | Professional | 54 · Surgery only | $229.09 | $263.03 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $52.48 Typical High $67.61 | Professional | 55 · Aftercare only | $45.71 | $52.48 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $34.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $30.20 | $34.67 | $44.67 |
Where Virginia sits
The same service costs 2.9 times more in Alaska than in Kentucky. 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
$380
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.