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 $37.15 Median $4,365.16 Typical High $14,125.38 | Facility | None | $37.15 | $4,365.16 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $52.48 Typical High $72.44 | Professional | None | $36.31 | $52.48 | $72.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $32.36 Median $48.98 Typical High $69.18 | Professional | None | $32.36 | $48.98 | $69.18 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $794.33 Typical High $2,691.53 | Facility | None | $512.86 | $794.33 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
Kaiser Permanente Setting Professional Modifier None Typical Low $26.30 Median $58.88 Typical High $72.44 | Professional | None | $26.30 | $58.88 | $72.44 |
Medcost Setting Professional Modifier None Typical Low $52.48 Median $66.07 Typical High $66.07 | Professional | None | $52.48 | $66.07 | $66.07 |
Medcost Setting Facility Modifier None Typical Low $37.15 Median $54.95 Typical High $89.13 | Facility | None | $37.15 | $54.95 | $89.13 |
Medcost Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
Sentara Setting Facility Modifier None Typical Low $31.62 Median $309.03 Typical High $2,454.71 | Facility | None | $31.62 | $309.03 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $44.67 Median $64.57 Typical High $870.96 | Professional | None | $44.67 | $64.57 | $870.96 |
United Setting Facility Modifier None Typical Low $100.00 Median $660.69 Typical High $2,089.30 | Facility | None | $100.00 | $660.69 | $2,089.30 |
United Setting Professional Modifier None Typical Low $28.84 Median $47.86 Typical High $85.11 | Professional | None | $28.84 | $47.86 | $85.11 |
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 $18.20 Median $18.62 Typical High $29.51 | Professional | 52 · Reduced service | $18.20 | $18.62 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $7.59 Typical High $11.75 | Professional | 53 · Discontinued | $7.24 | $7.59 | $11.75 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $26.92 Median $28.18 Typical High $43.65 | Professional | 54 · Surgery only | $26.92 | $28.18 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $5.62 Typical High $8.71 | Professional | 55 · Aftercare only | $5.37 | $5.62 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.80 Typical High $5.89 | Professional | 56 · Pre-op care only | $3.63 | $3.80 | $5.89 |
Where Virginia sits
The same service costs 2.8 times more in Alaska than in California. 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· 33rd of 51
$51.29
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.