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 $144.54 Median $5,495.41 Typical High $14,125.38 | Facility | None | $144.54 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $144.54 Typical High $239.88 | Professional | None | $131.83 | $144.54 | $239.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $123.03 Median $147.91 Typical High $181.97 | Professional | None | $123.03 | $147.91 | $181.97 |
CareFirst Setting Professional Modifier None Typical Low $128.82 Median $144.54 Typical High $144.54 | Professional | None | $128.82 | $144.54 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $331.13 Typical High $380.19 | Facility | None | $151.36 | $331.13 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $144.54 Typical High $208.93 | Professional | None | $112.20 | $144.54 | $208.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $125.89 Median $158.49 Typical High $186.21 | Professional | None | $125.89 | $158.49 | $186.21 |
Medcost Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $154.88 | Professional | None | $53.70 | $53.70 | $154.88 |
Medcost Setting Facility Modifier None Typical Low $131.83 Median $162.18 Typical High $223.87 | Facility | None | $131.83 | $162.18 | $223.87 |
Medcost Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
Sentara Setting Facility Modifier None Typical Low $107.15 Median $371.54 Typical High $2,454.71 | Facility | None | $107.15 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $123.03 Median $169.82 Typical High $1,071.52 | Professional | None | $123.03 | $169.82 | $1,071.52 |
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 $93.33 Median $131.83 Typical High $229.09 | Professional | None | $93.33 | $131.83 | $229.09 |
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 $64.57 Median $70.79 Typical High $72.44 | Professional | 52 · Reduced service | $64.57 | $70.79 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $28.18 Typical High $28.84 | Professional | 53 · Discontinued | $26.30 | $28.18 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $107.15 Typical High $109.65 | Professional | 54 · Surgery only | $97.72 | $107.15 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $20.89 Typical High $21.88 | Professional | 55 · Aftercare only | $19.50 | $20.89 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $14.13 Typical High $14.45 | Professional | 56 · Pre-op care only | $13.18 | $14.13 | $14.45 |
Where Virginia sits
The same service costs 3.2 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· 32nd of 51
$148
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.