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 $89.13 Median $4,786.30 Typical High $14,125.38 | Facility | None | $89.13 | $4,786.30 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $158.49 Typical High $3,235.94 | Professional | None | $47.86 | $158.49 | $3,235.94 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $32.36 | Professional | None | $19.50 | $19.50 | $32.36 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,230.27 Typical High $2,691.53 | Facility | None | $512.86 | $1,230.27 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | None | $5.50 | $5.50 | $5.50 |
Kaiser Permanente Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
Medcost Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $239.88 | Facility | None | $158.49 | $158.49 | $239.88 |
Sentara Setting Facility Modifier None Typical Low $371.54 Median $1,071.52 Typical High $10,232.93 | Facility | None | $371.54 | $1,071.52 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $870.96 Median $1,479.11 Typical High $11,481.54 | Professional | None | $870.96 | $1,479.11 | $11,481.54 |
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 |
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 $23.99 Median $77.62 Typical High $77.62 | Professional | 52 · Reduced service | $23.99 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $31.62 Typical High $31.62 | Professional | 53 · Discontinued | $9.55 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $117.49 Typical High $117.49 | Professional | 54 · Surgery only | $36.31 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $23.44 Typical High $23.44 | Professional | 55 · Aftercare only | $7.24 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $15.85 Typical High $15.85 | Professional | 56 · Pre-op care only | $4.79 | $15.85 | $15.85 |
Where Virginia sits
The same service costs 281.8 times more in North Dakota than in Vermont. 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· 15th of 51
$372
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.