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 $87.10 Median $4,073.80 Typical High $10,000.00 | Facility | None | $87.10 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $144.54 Typical High $186.21 | Professional | None | $74.13 | $144.54 | $186.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $74.13 Median $138.04 Typical High $213.80 | Professional | None | $74.13 | $138.04 | $213.80 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $109.65 Median $204.17 Typical High $323.59 | Professional | 50 · Both sides | $109.65 | $204.17 | $323.59 |
CareFirst Setting Professional Modifier None Typical Low $85.11 Median $95.50 Typical High $125.89 | Professional | None | $85.11 | $95.50 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $154.88 Typical High $257.04 | Professional | None | $75.86 | $154.88 | $257.04 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $181.97 Typical High $229.09 | Professional | None | $154.88 | $181.97 | $229.09 |
Medcost Setting Professional Modifier None Typical Low $208.93 Median $263.03 Typical High $263.03 | Professional | None | $208.93 | $263.03 | $263.03 |
Medcost Setting Facility Modifier None Typical Low $114.82 Median $144.54 Typical High $302.00 | Facility | None | $114.82 | $144.54 | $302.00 |
Medcost Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $204.17 | Professional | None | $72.44 | $72.44 | $204.17 |
Sentara Setting Facility Modifier None Typical Low $67.61 Median $147.91 Typical High $10,232.93 | Facility | None | $67.61 | $147.91 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $165.96 Median $208.93 Typical High $426.58 | Professional | None | $165.96 | $208.93 | $426.58 |
United Setting Facility Modifier None Typical Low $204.17 Median $1,023.29 Typical High $2,398.83 | Facility | None | $204.17 | $1,023.29 | $2,398.83 |
United Setting Professional Modifier None Typical Low $66.07 Median $141.25 Typical High $288.40 | Professional | None | $66.07 | $141.25 | $288.40 |
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 $37.15 Median $52.48 Typical High $93.33 | Professional | 52 · Reduced service | $37.15 | $52.48 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $20.89 Typical High $37.15 | Professional | 53 · Discontinued | $14.79 | $20.89 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $79.43 Typical High $138.04 | Professional | 54 · Surgery only | $56.23 | $79.43 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $15.85 Typical High $27.54 | Professional | 55 · Aftercare only | $11.22 | $15.85 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $10.47 Typical High $18.62 | Professional | 56 · Pre-op care only | $7.41 | $10.47 | $18.62 |
Where Virginia sits
The same service costs 2.6 times more in Wisconsin than in Utah. 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· 35th of 51
$151
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.