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 $51.29 Median $85.11 Typical High $8,317.64 | Facility | None | $51.29 | $85.11 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $52.48 Typical High $89.13 | Professional | None | $36.31 | $52.48 | $89.13 |
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 $38.02 Median $46.77 Typical High $53.70 | Professional | None | $38.02 | $46.77 | $53.70 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $57.54 Median $69.18 Typical High $81.28 | Professional | 50 · Both sides | $57.54 | $69.18 | $81.28 |
CareFirst Setting Professional Modifier None Typical Low $41.69 Median $45.71 Typical High $53.70 | Professional | None | $41.69 | $45.71 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $1,230.27 | Facility | None | $50.12 | $50.12 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $51.29 Typical High $75.86 | Professional | None | $37.15 | $51.29 | $75.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $61.66 Median $72.44 Typical High $91.20 | Professional | None | $61.66 | $72.44 | $91.20 |
Medcost Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $83.18 | Professional | None | $70.79 | $70.79 | $83.18 |
Medcost Setting Facility Modifier None Typical Low $36.31 Median $54.95 Typical High $107.15 | Facility | None | $36.31 | $54.95 | $107.15 |
Medcost Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
Sentara Setting Facility Modifier None Typical Low $38.02 Median $223.87 Typical High $2,454.71 | Facility | None | $38.02 | $223.87 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $57.54 Median $79.43 Typical High $870.96 | Professional | None | $57.54 | $79.43 | $870.96 |
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 $33.11 Median $50.12 Typical High $91.20 | Professional | None | $33.11 | $50.12 | $91.20 |
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 $18.20 Median $26.30 Typical High $38.90 | Professional | 52 · Reduced service | $18.20 | $26.30 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $10.47 Typical High $15.49 | Professional | 53 · Discontinued | $7.24 | $10.47 | $15.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $26.92 Median $38.90 Typical High $58.88 | Professional | 54 · Surgery only | $26.92 | $38.90 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $7.76 Typical High $11.75 | Professional | 55 · Aftercare only | $5.37 | $7.76 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $5.25 Typical High $7.76 | Professional | 56 · Pre-op care only | $3.63 | $5.25 | $7.76 |
Where Virginia sits
The same service costs 3.8 times more in Alaska than in Maryland. 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· 46th of 51
$52.48
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.