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 $112.20 Typical High $8,317.64 | Facility | None | $54.95 | $112.20 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $89.13 Typical High $177.83 | Professional | None | $51.29 | $89.13 | $177.83 |
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 $44.67 Median $52.48 Typical High $67.61 | Professional | None | $44.67 | $52.48 | $67.61 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $66.07 Median $79.43 Typical High $102.33 | Professional | 50 · Both sides | $66.07 | $79.43 | $102.33 |
CareFirst Setting Professional Modifier None Typical Low $48.98 Median $54.95 Typical High $691.83 | Professional | None | $48.98 | $54.95 | $691.83 |
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 $47.86 Median $79.43 Typical High $154.88 | Professional | None | $47.86 | $79.43 | $154.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $64.57 Median $97.72 Typical High $169.82 | Professional | None | $64.57 | $97.72 | $169.82 |
Medcost Setting Professional Modifier None Typical Low $147.91 Median $186.21 Typical High $186.21 | Professional | None | $147.91 | $186.21 | $186.21 |
Medcost Setting Facility Modifier None Typical Low $52.48 Median $87.10 Typical High $154.88 | Facility | None | $52.48 | $87.10 | $154.88 |
Medcost Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Sentara Setting Facility Modifier None Typical Low $48.98 Median $223.87 Typical High $2,454.71 | Facility | None | $48.98 | $223.87 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $77.62 Median $134.90 Typical High $870.96 | Professional | None | $77.62 | $134.90 | $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 $43.65 Median $83.18 Typical High $165.96 | Professional | None | $43.65 | $83.18 | $165.96 |
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 $35.48 Typical High $45.71 | Professional | 52 · Reduced service | $25.12 | $35.48 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $14.13 Typical High $18.20 | Professional | 53 · Discontinued | $10.23 | $14.13 | $18.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $52.48 Typical High $67.61 | Professional | 54 · Surgery only | $38.02 | $52.48 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $10.47 Typical High $13.49 | Professional | 55 · Aftercare only | $7.59 | $10.47 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $7.08 Typical High $9.12 | Professional | 56 · Pre-op care only | $5.13 | $7.08 | $9.12 |
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· 49th of 51
$72.44
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.