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 $208.93 Median $4,786.30 Typical High $10,000.00 | Facility | None | $208.93 | $4,786.30 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $208.93 Typical High $245.47 | Professional | None | $181.97 | $208.93 | $245.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $165.96 Median $199.53 Typical High $239.88 | Professional | None | $165.96 | $199.53 | $239.88 |
CareFirst Setting Professional Modifier None Typical Low $173.78 Median $194.98 Typical High $229.09 | Professional | None | $173.78 | $194.98 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $912.01 Typical High $2,691.53 | Facility | None | $457.09 | $912.01 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $177.83 Typical High $269.15 | Professional | None | $162.18 | $177.83 | $269.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $147.91 Median $177.83 Typical High $218.78 | Professional | None | $147.91 | $177.83 | $218.78 |
Medcost Setting Professional Modifier None Typical Low $263.03 Median $331.13 Typical High $331.13 | Professional | None | $263.03 | $331.13 | $331.13 |
Medcost Setting Facility Modifier None Typical Low $208.93 Median $251.19 Typical High $338.84 | Facility | None | $208.93 | $251.19 | $338.84 |
Medcost Setting Professional Modifier None Typical Low $229.09 Median $234.42 Typical High $275.42 | Professional | None | $229.09 | $234.42 | $275.42 |
Sentara Setting Facility Modifier None Typical Low $173.78 Median $371.54 Typical High $2,454.71 | Facility | None | $173.78 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $177.83 Median $239.88 Typical High $436.52 | Professional | None | $177.83 | $239.88 | $436.52 |
United Setting Facility Modifier None Typical Low $100.00 Median $660.69 Typical High $2,089.30 | Facility | None | $100.00 | $660.69 | $2,089.30 |
United Setting Professional Modifier None Typical Low $123.03 Median $173.78 Typical High $331.13 | Professional | None | $123.03 | $173.78 | $331.13 |
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 $91.20 Median $102.33 Typical High $102.33 | Professional | 52 · Reduced service | $91.20 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $41.69 Typical High $41.69 | Professional | 53 · Discontinued | $36.31 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $154.88 Typical High $154.88 | Professional | 54 · Surgery only | $134.90 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $30.90 Typical High $30.90 | Professional | 55 · Aftercare only | $27.54 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $20.89 Typical High $20.89 | Professional | 56 · Pre-op care only | $18.20 | $20.89 | $20.89 |
Where Virginia sits
The same service costs 4.5 times more in Alaska than in New York. 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· 38th of 51
$200
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.