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 $54.95 Median $4,365.16 Typical High $14,125.38 | Facility | None | $54.95 | $4,365.16 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $97.72 Typical High $173.78 | Professional | None | $50.12 | $97.72 | $173.78 |
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 $42.66 Median $51.29 Typical High $66.07 | Professional | None | $42.66 | $51.29 | $66.07 |
CareFirst Setting Professional Modifier None Typical Low $50.12 Median $54.95 Typical High $691.83 | Professional | None | $50.12 | $54.95 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $173.78 Typical High $1,621.81 | Facility | None | $64.57 | $173.78 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $91.20 Typical High $144.54 | Professional | None | $46.77 | $91.20 | $144.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $36.31 Median $109.65 Typical High $134.90 | Professional | None | $36.31 | $109.65 | $134.90 |
Medcost Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $147.91 | Professional | None | $117.49 | $147.91 | $147.91 |
Medcost Setting Facility Modifier None Typical Low $54.95 Median $89.13 Typical High $177.83 | Facility | None | $54.95 | $89.13 | $177.83 |
Medcost Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Sentara Setting Facility Modifier None Typical Low $45.71 Median $371.54 Typical High $2,454.71 | Facility | None | $45.71 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $87.10 Median $125.89 Typical High $870.96 | Professional | None | $87.10 | $125.89 | $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 $87.10 Typical High $169.82 | Professional | None | $41.69 | $87.10 | $169.82 |
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 $25.12 Median $41.69 Typical High $54.95 | Professional | 52 · Reduced service | $25.12 | $41.69 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $16.98 Typical High $21.88 | Professional | 53 · Discontinued | $10.00 | $16.98 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $63.10 Typical High $81.28 | Professional | 54 · Surgery only | $37.15 | $63.10 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $12.59 Typical High $16.22 | Professional | 55 · Aftercare only | $7.41 | $12.59 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $8.51 Typical High $10.96 | Professional | 56 · Pre-op care only | $5.01 | $8.51 | $10.96 |
Where Virginia sits
The same service costs 3.3 times more in Alaska than in Kentucky. 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· 50th of 51
$70.79
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.