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 $89.13 Median $3,801.89 Typical High $9,332.54 | Facility | None | $89.13 | $3,801.89 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $89.13 Typical High $134.90 | Professional | None | $54.95 | $89.13 | $134.90 |
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 $51.29 Median $61.66 Typical High $74.13 | Professional | None | $51.29 | $61.66 | $74.13 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $77.62 Median $93.33 Typical High $112.20 | Professional | 50 · Both sides | $77.62 | $93.33 | $112.20 |
CareFirst Setting Professional Modifier None Typical Low $53.70 Median $60.26 Typical High $79.43 | Professional | None | $53.70 | $60.26 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $138.04 Typical High $1,621.81 | Facility | None | $51.29 | $138.04 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $83.18 Typical High $173.78 | Professional | None | $53.70 | $83.18 | $173.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $87.10 Median $104.71 Typical High $131.83 | Professional | None | $87.10 | $104.71 | $131.83 |
Medcost Setting Professional Modifier None Typical Low $186.21 Median $234.42 Typical High $234.42 | Professional | None | $186.21 | $234.42 | $234.42 |
Medcost Setting Facility Modifier None Typical Low $64.57 Median $104.71 Typical High $173.78 | Facility | None | $64.57 | $104.71 | $173.78 |
Medcost Setting Professional Modifier None Typical Low $89.13 Median $109.65 Typical High $165.96 | Professional | None | $89.13 | $109.65 | $165.96 |
Sentara Setting Facility Modifier None Typical Low $58.88 Median $616.60 Typical High $2,951.21 | Facility | None | $58.88 | $616.60 | $2,951.21 |
Sentara Setting Professional Modifier None Typical Low $95.50 Median $162.18 Typical High $234.42 | Professional | None | $95.50 | $162.18 | $234.42 |
United Setting Facility Modifier None Typical Low $323.59 Median $1,445.44 Typical High $3,630.78 | Facility | None | $323.59 | $1,445.44 | $3,630.78 |
United Setting Professional Modifier None Typical Low $41.69 Median $75.86 Typical High $181.97 | Professional | None | $41.69 | $75.86 | $181.97 |
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 $27.54 Median $39.81 Typical High $53.70 | Professional | 52 · Reduced service | $27.54 | $39.81 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $15.85 Typical High $21.38 | Professional | 53 · Discontinued | $10.96 | $15.85 | $21.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $58.88 Typical High $79.43 | Professional | 54 · Surgery only | $41.69 | $58.88 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $11.75 Typical High $15.85 | Professional | 55 · Aftercare only | $8.32 | $11.75 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $7.94 Typical High $10.72 | Professional | 56 · Pre-op care only | $5.50 | $7.94 | $10.72 |
Where Virginia sits
The same service costs 3.2 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· 50th of 51
$70.79
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.