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 $134.90 Median $3,235.94 Typical High $9,332.54 | Facility | None | $134.90 | $3,235.94 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $186.21 Typical High $263.03 | Professional | None | $117.49 | $186.21 | $263.03 |
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 $109.65 Median $128.82 Typical High $158.49 | Professional | None | $109.65 | $128.82 | $158.49 |
CareFirst Setting Professional Modifier None Typical Low $109.65 Median $123.03 Typical High $144.54 | Professional | None | $109.65 | $123.03 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $147.91 Typical High $1,230.27 | Facility | None | $50.12 | $147.91 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $169.82 Typical High $245.47 | Professional | None | $107.15 | $169.82 | $245.47 |
Kaiser Permanente Setting Professional Modifier None Typical Low $186.21 Median $223.87 Typical High $281.84 | Professional | None | $186.21 | $223.87 | $281.84 |
Medcost Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
Medcost Setting Facility Modifier None Typical Low $134.90 Median $186.21 Typical High $309.03 | Facility | None | $134.90 | $186.21 | $309.03 |
Medcost Setting Professional Modifier None Typical Low $72.44 Median $95.50 Typical High $213.80 | Professional | None | $72.44 | $95.50 | $213.80 |
Sentara Setting Facility Modifier None Typical Low $117.49 Median $616.60 Typical High $2,951.21 | Facility | None | $117.49 | $616.60 | $2,951.21 |
Sentara Setting Professional Modifier None Typical Low $169.82 Median $204.17 Typical High $416.87 | Professional | None | $169.82 | $204.17 | $416.87 |
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 $85.11 Median $151.36 Typical High $275.42 | Professional | None | $85.11 | $151.36 | $275.42 |
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 $58.88 Median $79.43 Typical High $93.33 | Professional | 52 · Reduced service | $58.88 | $79.43 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $31.62 Typical High $38.02 | Professional | 53 · Discontinued | $23.44 | $31.62 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $117.49 Typical High $141.25 | Professional | 54 · Surgery only | $89.13 | $117.49 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $23.44 Typical High $28.18 | Professional | 55 · Aftercare only | $17.78 | $23.44 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $15.85 Typical High $18.62 | Professional | 56 · Pre-op care only | $11.75 | $15.85 | $18.62 |
Where Virginia sits
The same service costs 3.3 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
$141
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.