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 $33.11 Median $117.49 Typical High $8,317.64 | Facility | None | $33.11 | $117.49 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $79.43 Typical High $134.90 | Professional | None | $25.70 | $79.43 | $134.90 |
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 $33.11 Median $72.44 Typical High $123.03 | Professional | None | $33.11 | $72.44 | $123.03 |
CareFirst Setting Professional Modifier None Typical Low $27.54 Median $30.20 Typical High $31.62 | Professional | None | $27.54 | $30.20 | $31.62 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $58.88 Typical High $87.10 | Professional | None | $25.12 | $58.88 | $87.10 |
Kaiser Permanente Setting Professional Modifier None Typical Low $93.33 Median $123.03 Typical High $144.54 | Professional | None | $93.33 | $123.03 | $144.54 |
Medcost Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $77.62 | Professional | None | $67.61 | $67.61 | $77.62 |
Medcost Setting Facility Modifier None Typical Low $25.70 Median $45.71 Typical High $162.18 | Facility | None | $25.70 | $45.71 | $162.18 |
Medcost Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | None | $66.07 | $66.07 | $66.07 |
Sentara Setting Facility Modifier None Typical Low $28.18 Median $371.54 Typical High $2,454.71 | Facility | None | $28.18 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $46.77 Median $107.15 Typical High $870.96 | Professional | None | $46.77 | $107.15 | $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 $24.55 Median $47.86 Typical High $100.00 | Professional | None | $24.55 | $47.86 | $100.00 |
3 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 54 · Surgery only Typical Low $19.05 Median $44.67 Typical High $75.86 | Professional | 54 · Surgery only | $19.05 | $44.67 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $8.91 Typical High $15.14 | Professional | 55 · Aftercare only | $3.80 | $8.91 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $5.89 Typical High $10.00 | Professional | 56 · Pre-op care only | $2.57 | $5.89 | $10.00 |
Where Virginia sits
The same service costs 2.8 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· 26th of 51
$75.86
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.