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 $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $69.18 Typical High $69.18 | Professional | None | $63.10 | $69.18 | $69.18 |
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 |
CareFirst Setting Professional Modifier None Typical Low $123.03 Median $134.90 Typical High $177.83 | Professional | None | $123.03 | $134.90 | $177.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $74.13 Median $89.13 Typical High $109.65 | Professional | None | $74.13 | $89.13 | $109.65 |
Medcost Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $104.71 | Facility | None | $57.54 | $57.54 | $104.71 |
Medcost Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Sentara Setting Facility Modifier None Typical Low $58.88 Median $912.01 Typical High $10,232.93 | Facility | None | $58.88 | $912.01 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $58.88 Median $72.44 Typical High $10,232.93 | Professional | None | $58.88 | $72.44 | $10,232.93 |
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 $46.77 Median $51.29 Typical High $51.29 | Professional | 54 · Surgery only | $46.77 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $10.47 Typical High $10.47 | Professional | 55 · Aftercare only | $9.33 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.92 Typical High $6.92 | Professional | 56 · Pre-op care only | $6.31 | $6.92 | $6.92 |
Where Virginia sits
The same service costs 123.0 times more in Alabama than in New Jersey. 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· 30th 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.