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 $33.88 Median $4,786.30 Typical High $14,125.38 | Facility | None | $33.88 | $4,786.30 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $33.88 Typical High $37.15 | Professional | None | $24.55 | $33.88 | $37.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.12 Median $30.20 Typical High $35.48 | Professional | None | $25.12 | $30.20 | $35.48 |
CareFirst Setting Professional Modifier None Typical Low $26.30 Median $28.84 Typical High $34.67 | Professional | None | $26.30 | $28.84 | $34.67 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $676.08 Typical High $2,691.53 | Facility | None | $346.74 | $676.08 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $27.54 Typical High $40.74 | Professional | None | $24.55 | $27.54 | $40.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $27.54 Median $32.36 Typical High $40.74 | Professional | None | $27.54 | $32.36 | $40.74 |
Medcost Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $48.98 | Professional | None | $38.90 | $38.90 | $48.98 |
Medcost Setting Facility Modifier None Typical Low $24.55 Median $35.48 Typical High $53.70 | Facility | None | $24.55 | $35.48 | $53.70 |
Medcost Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
Sentara Setting Facility Modifier None Typical Low $25.70 Median $354.81 Typical High $2,454.71 | Facility | None | $25.70 | $354.81 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $29.51 Median $34.67 Typical High $870.96 | Professional | None | $29.51 | $34.67 | $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 $21.38 Median $28.84 Typical High $48.98 | Professional | None | $21.38 | $28.84 | $48.98 |
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 $12.02 Median $16.98 Typical High $18.20 | Professional | 52 · Reduced service | $12.02 | $16.98 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $6.92 Typical High $7.24 | Professional | 53 · Discontinued | $4.90 | $6.92 | $7.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $18.20 Median $25.70 Typical High $27.54 | Professional | 54 · Surgery only | $18.20 | $25.70 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $5.13 Typical High $5.50 | Professional | 55 · Aftercare only | $3.63 | $5.13 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $3.39 Typical High $3.63 | Professional | 56 · Pre-op care only | $2.45 | $3.39 | $3.63 |
Where Virginia sits
The same service costs 4.1 times more in Alaska than in New Jersey. 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· 41st of 51
$31.62
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.