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 $53.70 Median $4,073.80 Typical High $10,000.00 | Facility | None | $53.70 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $61.66 Typical High $74.13 | Professional | None | $47.86 | $61.66 | $74.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $47.86 Median $57.54 Typical High $72.44 | Professional | None | $47.86 | $57.54 | $72.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $70.79 Median $85.11 Typical High $107.15 | Professional | 50 · Both sides | $70.79 | $85.11 | $107.15 |
CareFirst Setting Professional Modifier None Typical Low $50.12 Median $56.23 Typical High $72.44 | Professional | None | $50.12 | $56.23 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $63.10 Typical High $107.15 | Professional | None | $47.86 | $63.10 | $107.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $54.95 Median $63.10 Typical High $81.28 | Professional | None | $54.95 | $63.10 | $81.28 |
Medcost Setting Professional Modifier None Typical Low $83.18 Median $104.71 Typical High $891.25 | Professional | None | $83.18 | $104.71 | $891.25 |
Medcost Setting Facility Modifier None Typical Low $75.86 Median $83.18 Typical High $114.82 | Facility | None | $75.86 | $83.18 | $114.82 |
Medcost Setting Professional Modifier None Typical Low $54.95 Median $77.62 Typical High $87.10 | Professional | None | $54.95 | $77.62 | $87.10 |
Sentara Setting Facility Modifier None Typical Low $40.74 Median $104.71 Typical High $10,232.93 | Facility | None | $40.74 | $104.71 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $63.10 Median $87.10 Typical High $549.54 | Professional | None | $63.10 | $87.10 | $549.54 |
United Setting Facility Modifier None Typical Low $204.17 Median $1,023.29 Typical High $2,398.83 | Facility | None | $204.17 | $1,023.29 | $2,398.83 |
United Setting Professional Modifier None Typical Low $47.86 Median $74.13 Typical High $125.89 | Professional | None | $47.86 | $74.13 | $125.89 |
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 $23.99 Median $29.51 Typical High $37.15 | Professional | 52 · Reduced service | $23.99 | $29.51 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $11.75 Typical High $14.79 | Professional | 53 · Discontinued | $9.55 | $11.75 | $14.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $43.65 Typical High $56.23 | Professional | 54 · Surgery only | $36.31 | $43.65 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $8.71 Typical High $11.22 | Professional | 55 · Aftercare only | $7.24 | $8.71 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $5.89 Typical High $7.41 | Professional | 56 · Pre-op care only | $4.79 | $5.89 | $7.41 |
Where Virginia sits
The same service costs 3.4 times more in Alaska 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· 45th of 51
$60.26
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.