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 $17.78 Median $3,801.89 Typical High $9,332.54 | Facility | None | $17.78 | $3,801.89 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $15.49 Median $17.78 Typical High $37.15 | Professional | None | $15.49 | $17.78 | $37.15 |
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 $15.14 Median $17.78 Typical High $22.39 | Professional | None | $15.14 | $17.78 | $22.39 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $22.39 Median $26.92 Typical High $34.67 | Professional | 50 · Both sides | $22.39 | $26.92 | $34.67 |
CareFirst Setting Professional Modifier None Typical Low $16.22 Median $18.20 Typical High $23.99 | Professional | None | $16.22 | $18.20 | $23.99 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $524.81 Typical High $3,019.95 | Facility | None | $50.12 | $524.81 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $14.45 Median $17.38 Typical High $25.12 | Professional | None | $14.45 | $17.38 | $25.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $16.60 Median $19.95 Typical High $25.12 | Professional | None | $16.60 | $19.95 | $25.12 |
Medcost Setting Facility Modifier None Typical Low $15.49 Median $16.98 Typical High $25.70 | Facility | None | $15.49 | $16.98 | $25.70 |
Medcost Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | None | $16.60 | $16.60 | $16.60 |
Sentara Setting Facility Modifier None Typical Low $12.88 Median $102.33 Typical High $2,454.71 | Facility | None | $12.88 | $102.33 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $14.13 Median $18.62 Typical High $870.96 | Professional | None | $14.13 | $18.62 | $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 $11.48 Median $18.62 Typical High $28.18 | Professional | None | $11.48 | $18.62 | $28.18 |
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 $7.76 Median $7.76 Typical High $8.91 | Professional | 52 · Reduced service | $7.76 | $7.76 | $8.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.09 Median $3.09 Typical High $3.55 | Professional | 53 · Discontinued | $3.09 | $3.09 | $3.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $11.75 Median $11.75 Typical High $13.49 | Professional | 54 · Surgery only | $11.75 | $11.75 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.34 Median $2.34 Typical High $2.69 | Professional | 55 · Aftercare only | $2.34 | $2.34 | $2.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.55 Median $1.55 Typical High $1.78 | Professional | 56 · Pre-op care only | $1.55 | $1.55 | $1.78 |
Where Virginia sits
The same service costs 7.4 times more in Kansas 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· 40th of 51
$18.62
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.