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 $85.11 Median $3,981.07 Typical High $10,000.00 | Facility | None | $85.11 | $3,981.07 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $91.20 Typical High $154.88 | Professional | None | $43.65 | $91.20 | $154.88 |
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 $40.74 Median $48.98 Typical High $58.88 | Professional | None | $40.74 | $48.98 | $58.88 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $61.66 Median $74.13 Typical High $89.13 | Professional | 50 · Both sides | $61.66 | $74.13 | $89.13 |
CareFirst Setting Professional Modifier None Typical Low $43.65 Median $47.86 Typical High $63.10 | Professional | None | $43.65 | $47.86 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $46.77 Median $128.82 Typical High $1,621.81 | Facility | None | $46.77 | $128.82 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $79.43 Typical High $173.78 | Professional | None | $42.66 | $79.43 | $173.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $72.44 Median $87.10 Typical High $109.65 | Professional | None | $72.44 | $87.10 | $109.65 |
Medcost Setting Professional Modifier None Typical Low $199.53 Median $245.47 Typical High $245.47 | Professional | None | $199.53 | $245.47 | $245.47 |
Medcost Setting Facility Modifier None Typical Low $91.20 Median $151.36 Typical High $257.04 | Facility | None | $91.20 | $151.36 | $257.04 |
Medcost Setting Professional Modifier None Typical Low $89.13 Median $109.65 Typical High $173.78 | Professional | None | $89.13 | $109.65 | $173.78 |
Sentara Setting Facility Modifier None Typical Low $54.95 Median $616.60 Typical High $2,951.21 | Facility | None | $54.95 | $616.60 | $2,951.21 |
Sentara Setting Professional Modifier None Typical Low $91.20 Median $162.18 Typical High $269.15 | Professional | None | $91.20 | $162.18 | $269.15 |
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 $33.88 Median $74.13 Typical High $186.21 | Professional | None | $33.88 | $74.13 | $186.21 |
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 $21.88 Median $45.71 Typical High $77.62 | Professional | 52 · Reduced service | $21.88 | $45.71 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $18.62 Typical High $31.62 | Professional | 53 · Discontinued | $8.71 | $18.62 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $69.18 Typical High $117.49 | Professional | 54 · Surgery only | $33.11 | $69.18 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $13.80 Typical High $23.44 | Professional | 55 · Aftercare only | $6.61 | $13.80 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $9.12 Typical High $15.49 | Professional | 56 · Pre-op care only | $4.37 | $9.12 | $15.49 |
Where Virginia sits
The same service costs 3.2 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.