How much rates vary
Facilitymedian $1,514 · 10th to 90th $83 to $5,623Professionalmedian $83 · 10th to 90th $60 to $209
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 $70.79 Median $309.03 Typical High $10,000.00 | Facility | None | $70.79 | $309.03 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $138.04 Typical High $165.96 | Professional | None | $69.18 | $138.04 | $165.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $3,715.35 Typical High $4,265.80 | Facility | None | $2,884.03 | $3,715.35 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $72.44 Typical High $91.20 | Professional | None | $60.26 | $72.44 | $91.20 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $89.13 Median $107.15 Typical High $138.04 | Professional | 50 · Both sides | $89.13 | $107.15 | $138.04 |
CareFirst Setting Professional Modifier None Typical Low $66.07 Median $74.13 Typical High $2,511.89 | Professional | None | $66.07 | $74.13 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $218.78 Typical High $2,691.53 | Facility | None | $114.82 | $218.78 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $134.90 Typical High $218.78 | Professional | None | $66.07 | $134.90 | $218.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $56.23 Median $169.82 Typical High $208.93 | Professional | None | $56.23 | $169.82 | $208.93 |
Medcost Setting Professional Modifier None Typical Low $151.36 Median $190.55 Typical High $190.55 | Professional | None | $151.36 | $190.55 | $190.55 |
Medcost Setting Facility Modifier None Typical Low $70.79 Median $114.82 Typical High $257.04 | Facility | None | $70.79 | $114.82 | $257.04 |
Medcost Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Sentara Setting Facility Modifier None Typical Low $61.66 Median $891.25 Typical High $3,981.07 | Facility | None | $61.66 | $891.25 | $3,981.07 |
Sentara Setting Professional Modifier None Typical Low $100.00 Median $181.97 Typical High $2,137.96 | Professional | None | $100.00 | $181.97 | $2,137.96 |
United Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $5,888.44 | Facility | None | $588.84 | $2,187.76 | $5,888.44 |
United Setting Professional Modifier None Typical Low $54.95 Median $114.82 Typical High $245.47 | Professional | None | $54.95 | $114.82 | $245.47 |
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 $34.67 Median $60.26 Typical High $83.18 | Professional | 52 · Reduced service | $34.67 | $60.26 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $24.55 Typical High $33.11 | Professional | 53 · Discontinued | $13.80 | $24.55 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $91.20 Typical High $123.03 | Professional | 54 · Surgery only | $52.48 | $91.20 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $18.20 Typical High $24.55 | Professional | 55 · Aftercare only | $10.47 | $18.20 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $12.02 Typical High $16.60 | Professional | 56 · Pre-op care only | $6.92 | $12.02 | $16.60 |
Where Virginia sits
The same service costs 5.9 times more in Oklahoma 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
$93.33
OK $468KY $79.43
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.