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 $74.13 Median $181.97 Typical High $8,317.64 | Facility | None | $74.13 | $181.97 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $79.43 Typical High $151.36 | Professional | None | $53.70 | $79.43 | $151.36 |
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 $58.88 Typical High $70.79 | Professional | None | $48.98 | $58.88 | $70.79 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $74.13 Median $89.13 Typical High $107.15 | Professional | 50 · Both sides | $74.13 | $89.13 | $107.15 |
CareFirst Setting Professional Modifier None Typical Low $54.95 Median $61.66 Typical High $72.44 | Professional | None | $54.95 | $61.66 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $41.69 Median $112.20 Typical High $1,621.81 | Facility | None | $41.69 | $112.20 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $75.86 Typical High $134.90 | Professional | None | $51.29 | $75.86 | $134.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $75.86 Median $91.20 Typical High $114.82 | Professional | None | $75.86 | $91.20 | $114.82 |
Medcost Setting Professional Modifier None Typical Low $138.04 Median $173.78 Typical High $173.78 | Professional | None | $138.04 | $173.78 | $173.78 |
Medcost Setting Facility Modifier None Typical Low $60.26 Median $100.00 Typical High $151.36 | Facility | None | $60.26 | $100.00 | $151.36 |
Medcost Setting Professional Modifier None Typical Low $72.44 Median $95.50 Typical High $134.90 | Professional | None | $72.44 | $95.50 | $134.90 |
Sentara Setting Facility Modifier None Typical Low $56.23 Median $371.54 Typical High $2,454.71 | Facility | None | $56.23 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $81.28 Median $123.03 Typical High $194.98 | Professional | None | $81.28 | $123.03 | $194.98 |
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 $40.74 Median $70.79 Typical High $147.91 | Professional | None | $40.74 | $70.79 | $147.91 |
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 $26.30 Median $35.48 Typical High $46.77 | Professional | 52 · Reduced service | $26.30 | $35.48 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $14.45 Typical High $18.62 | Professional | 53 · Discontinued | $10.72 | $14.45 | $18.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $53.70 Typical High $69.18 | Professional | 54 · Surgery only | $39.81 | $53.70 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $10.72 Typical High $13.80 | Professional | 55 · Aftercare only | $7.94 | $10.72 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $7.24 Typical High $9.33 | Professional | 56 · Pre-op care only | $5.37 | $7.24 | $9.33 |
Where Virginia sits
The same service costs 3.2 times more in Alaska than in Texas. 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· 49th of 51
$67.61
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.