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 $27.54 Median $4,365.16 Typical High $14,125.38 | Facility | None | $27.54 | $4,365.16 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $23.99 Median $28.84 Typical High $79.43 | Professional | None | $23.99 | $28.84 | $79.43 |
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 $20.42 Median $24.55 Typical High $28.84 | Professional | None | $20.42 | $24.55 | $28.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $30.90 Median $37.15 Typical High $43.65 | Professional | 50 · Both sides | $30.90 | $37.15 | $43.65 |
CareFirst Setting Professional Modifier None Typical Low $21.88 Median $23.99 Typical High $28.18 | Professional | None | $21.88 | $23.99 | $28.18 |
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 $16.98 Median $25.70 Typical High $64.57 | Professional | None | $16.98 | $25.70 | $64.57 |
Kaiser Permanente Setting Professional Modifier None Typical Low $18.62 Median $20.89 Typical High $25.70 | Professional | None | $18.62 | $20.89 | $25.70 |
Medcost Setting Professional Modifier None Typical Low $85.11 Median $107.15 Typical High $107.15 | Professional | None | $85.11 | $107.15 | $107.15 |
Medcost Setting Facility Modifier None Typical Low $28.18 Median $63.10 Typical High $66.07 | Facility | None | $28.18 | $63.10 | $66.07 |
Medcost Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $61.66 | Professional | None | $57.54 | $57.54 | $61.66 |
Sentara Setting Facility Modifier None Typical Low $31.62 Median $218.78 Typical High $2,454.71 | Facility | None | $31.62 | $218.78 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $24.55 Median $63.10 Typical High $870.96 | Professional | None | $24.55 | $63.10 | $870.96 |
United Setting Facility Modifier None Typical Low $100.00 Median $645.65 Typical High $2,041.74 | Facility | None | $100.00 | $645.65 | $2,041.74 |
United Setting Professional Modifier None Typical Low $19.95 Median $39.81 Typical High $75.86 | Professional | None | $19.95 | $39.81 | $75.86 |
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 $13.80 Typical High $15.14 | Professional | 52 · Reduced service | $12.02 | $13.80 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $5.62 Typical High $6.03 | Professional | 53 · Discontinued | $4.79 | $5.62 | $6.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $18.20 Median $20.89 Typical High $22.39 | Professional | 54 · Surgery only | $18.20 | $20.89 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $4.17 Typical High $4.47 | Professional | 55 · Aftercare only | $3.63 | $4.17 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.40 Median $2.75 Typical High $3.02 | Professional | 56 · Pre-op care only | $2.40 | $2.75 | $3.02 |
Where Virginia sits
The same service costs 4.3 times more in Wyoming 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· 44th of 51
$28.84
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.