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 $63.10 Median $4,073.80 Typical High $10,000.00 | Facility | None | $63.10 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $66.07 Typical High $125.89 | Professional | None | $58.88 | $66.07 | $125.89 |
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 $43.65 Median $52.48 Typical High $61.66 | Professional | None | $43.65 | $52.48 | $61.66 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $64.57 Median $77.62 Typical High $91.20 | Professional | 50 · Both sides | $64.57 | $77.62 | $91.20 |
CareFirst Setting Professional Modifier None Typical Low $45.71 Median $50.12 Typical High $66.07 | Professional | None | $45.71 | $50.12 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $25.70 Median $69.18 Typical High $1,621.81 | Facility | None | $25.70 | $69.18 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $60.26 Typical High $112.20 | Professional | None | $42.66 | $60.26 | $112.20 |
Kaiser Permanente Setting Professional Modifier None Typical Low $48.98 Median $57.54 Typical High $72.44 | Professional | None | $48.98 | $57.54 | $72.44 |
Medcost Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $79.43 | Professional | None | $75.86 | $75.86 | $79.43 |
Medcost Setting Facility Modifier None Typical Low $63.10 Median $107.15 Typical High $144.54 | Facility | None | $63.10 | $107.15 | $144.54 |
Medcost Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
Sentara Setting Facility Modifier None Typical Low $44.67 Median $371.54 Typical High $2,454.71 | Facility | None | $44.67 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $50.12 Median $102.33 Typical High $870.96 | Professional | None | $50.12 | $102.33 | $870.96 |
United Setting Facility Modifier None Typical Low $100.00 Median $660.69 Typical High $2,041.74 | Facility | None | $100.00 | $660.69 | $2,041.74 |
United Setting Professional Modifier None Typical Low $41.69 Median $61.66 Typical High $131.83 | Professional | None | $41.69 | $61.66 | $131.83 |
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 $29.51 Median $30.90 Typical High $33.88 | Professional | 52 · Reduced service | $29.51 | $30.90 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $12.59 Typical High $13.49 | Professional | 53 · Discontinued | $11.75 | $12.59 | $13.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $46.77 Typical High $51.29 | Professional | 54 · Surgery only | $44.67 | $46.77 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $9.33 Typical High $10.23 | Professional | 55 · Aftercare only | $8.91 | $9.33 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $6.31 Typical High $6.76 | Professional | 56 · Pre-op care only | $5.89 | $6.31 | $6.76 |
Where Virginia sits
The same service costs 3.6 times more in Wyoming than in Florida. 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
$61.66
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.