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 $147.91 Median $5,623.41 Typical High $11,481.54 | Facility | None | $147.91 | $5,623.41 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $147.91 Typical High $3,981.07 | Professional | None | $131.83 | $147.91 | $3,981.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $3,715.35 Typical High $4,265.80 | Facility | None | $2,884.03 | $3,715.35 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $151.36 Typical High $190.55 | Professional | None | $125.89 | $151.36 | $190.55 |
CareFirst Setting Professional Modifier None Typical Low $128.82 Median $144.54 Typical High $2,511.89 | Professional | None | $128.82 | $144.54 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $1,819.70 Typical High $3,467.37 | Facility | None | $724.44 | $1,819.70 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $154.88 Typical High $234.42 | Professional | None | $125.89 | $154.88 | $234.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $114.82 Median $134.90 Typical High $169.82 | Professional | None | $114.82 | $134.90 | $169.82 |
Medcost Setting Professional Modifier None Typical Low $229.09 Median $281.84 Typical High $281.84 | Professional | None | $229.09 | $281.84 | $281.84 |
Medcost Setting Facility Modifier None Typical Low $147.91 Median $181.97 Typical High $245.47 | Facility | None | $147.91 | $181.97 | $245.47 |
Medcost Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Sentara Setting Facility Modifier None Typical Low $131.83 Median $912.01 Typical High $8,709.64 | Facility | None | $131.83 | $912.01 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $138.04 Median $177.83 Typical High $4,570.88 | Professional | None | $138.04 | $177.83 | $4,570.88 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $6,760.83 Typical High $16,595.87 | Facility | None | $1,548.82 | $6,760.83 | $16,595.87 |
United Setting Professional Modifier None Typical Low $109.65 Median $190.55 Typical High $269.15 | Professional | None | $109.65 | $190.55 | $269.15 |
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 $61.66 Median $74.13 Typical High $74.13 | Professional | 52 · Reduced service | $61.66 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $29.51 Typical High $29.51 | Professional | 53 · Discontinued | $25.12 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $112.20 Typical High $112.20 | Professional | 54 · Surgery only | $93.33 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $22.39 Typical High $22.39 | Professional | 55 · Aftercare only | $18.62 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $14.79 Typical High $14.79 | Professional | 56 · Pre-op care only | $12.30 | $14.79 | $14.79 |
Where Virginia sits
The same service costs 10.7 times more in Oklahoma 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· 47th of 51
$158
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.