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 $15.49 Median $5,495.41 Typical High $14,125.38 | Facility | None | $15.49 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $11.48 Median $14.45 Typical High $16.60 | Professional | None | $11.48 | $14.45 | $16.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $34.67 Median $43.65 Typical High $57.54 | Facility | None | $34.67 | $43.65 | $57.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.59 Median $14.79 Typical High $19.50 | Professional | None | $12.59 | $14.79 | $19.50 |
CareFirst Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | None | $10.72 | $10.72 | $10.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $10.96 Median $12.59 Typical High $16.22 | Professional | None | $10.96 | $12.59 | $16.22 |
Medcost Setting Professional Modifier None Typical Low $15.85 Median $19.95 Typical High $19.95 | Professional | None | $15.85 | $19.95 | $19.95 |
Medcost Setting Facility Modifier None Typical Low $20.42 Median $20.42 Typical High $25.70 | Facility | None | $20.42 | $20.42 | $25.70 |
Medcost Setting Professional Modifier None Typical Low $8.91 Median $12.02 Typical High $12.88 | Professional | None | $8.91 | $12.02 | $12.88 |
Sentara Setting Facility Modifier None Typical Low $10.00 Median $18.20 Typical High $10,232.93 | Facility | None | $10.00 | $18.20 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $12.59 Median $15.49 Typical High $32.36 | Professional | None | $12.59 | $15.49 | $32.36 |
United Setting Professional Modifier None Typical Low $10.00 Median $16.22 Typical High $25.12 | Professional | None | $10.00 | $16.22 | $25.12 |
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 $5.89 Median $7.24 Typical High $7.76 | Professional | 52 · Reduced service | $5.89 | $7.24 | $7.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.34 Median $2.88 Typical High $3.09 | Professional | 53 · Discontinued | $2.34 | $2.88 | $3.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $8.91 Median $10.72 Typical High $11.75 | Professional | 54 · Surgery only | $8.91 | $10.72 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.78 Median $2.14 Typical High $2.34 | Professional | 55 · Aftercare only | $1.78 | $2.14 | $2.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.17 Median $1.45 Typical High $1.55 | Professional | 56 · Pre-op care only | $1.17 | $1.45 | $1.55 |
Where Virginia sits
The same service costs 3.3 times more in Alaska than in Delaware. 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· 28th of 51
$14.79
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.