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 $87.10 Median $3,981.07 Typical High $10,000.00 | Facility | None | $87.10 | $3,981.07 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $95.50 Typical High $131.83 | Professional | None | $45.71 | $95.50 | $131.83 |
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 $41.69 Median $50.12 Typical High $60.26 | Professional | None | $41.69 | $50.12 | $60.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $63.10 Median $75.86 Typical High $91.20 | Professional | 50 · Both sides | $63.10 | $75.86 | $91.20 |
CareFirst Setting Professional Modifier None Typical Low $45.71 Median $50.12 Typical High $66.07 | Professional | None | $45.71 | $50.12 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $141.25 Typical High $1,621.81 | Facility | None | $52.48 | $141.25 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $81.28 Typical High $144.54 | Professional | None | $43.65 | $81.28 | $144.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $77.62 Median $93.33 Typical High $117.49 | Professional | None | $77.62 | $93.33 | $117.49 |
Medcost Setting Professional Modifier None Typical Low $151.36 Median $186.21 Typical High $186.21 | Professional | None | $151.36 | $186.21 | $186.21 |
Medcost Setting Facility Modifier None Typical Low $95.50 Median $131.83 Typical High $213.80 | Facility | None | $95.50 | $131.83 | $213.80 |
Medcost Setting Professional Modifier None Typical Low $109.65 Median $123.03 Typical High $147.91 | Professional | None | $109.65 | $123.03 | $147.91 |
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 $87.10 Median $138.04 Typical High $229.09 | Professional | None | $87.10 | $138.04 | $229.09 |
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 $33.88 Median $74.13 Typical High $158.49 | Professional | None | $33.88 | $74.13 | $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 $22.91 Median $47.86 Typical High $66.07 | Professional | 52 · Reduced service | $22.91 | $47.86 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $19.05 Typical High $26.30 | Professional | 53 · Discontinued | $9.12 | $19.05 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $72.44 Typical High $97.72 | Professional | 54 · Surgery only | $33.88 | $72.44 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $14.45 Typical High $19.50 | Professional | 55 · Aftercare only | $6.76 | $14.45 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $9.55 Typical High $13.18 | Professional | 56 · Pre-op care only | $4.57 | $9.55 | $13.18 |
Where Virginia sits
The same service costs 3.0 times more in Alaska than in Virginia. 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· 51st of 51
$60.26
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.