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 $93.33 Median $2,041.74 Typical High $9,332.54 | Facility | None | $93.33 | $2,041.74 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $213.80 Typical High $407.38 | Professional | None | $83.18 | $213.80 | $407.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $75.86 Median $91.20 Typical High $125.89 | Professional | None | $75.86 | $91.20 | $125.89 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $114.82 Median $134.90 Typical High $186.21 | Professional | 50 · Both sides | $114.82 | $134.90 | $186.21 |
CareFirst Setting Professional Modifier None Typical Low $79.43 Median $87.10 Typical High $114.82 | Professional | None | $79.43 | $87.10 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $218.78 Typical High $457.09 | Professional | None | $79.43 | $218.78 | $457.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $316.23 Median $380.19 Typical High $467.74 | Professional | None | $316.23 | $380.19 | $467.74 |
Medcost Setting Professional Modifier None Typical Low $338.84 Median $416.87 Typical High $645.65 | Professional | None | $338.84 | $416.87 | $645.65 |
Medcost Setting Facility Modifier None Typical Low $114.82 Median $154.88 Typical High $489.78 | Facility | None | $114.82 | $154.88 | $489.78 |
Medcost Setting Professional Modifier None Typical Low $123.03 Median $281.84 Typical High $354.81 | Professional | None | $123.03 | $281.84 | $354.81 |
Sentara Setting Facility Modifier None Typical Low $72.44 Median $158.49 Typical High $10,232.93 | Facility | None | $72.44 | $158.49 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $263.03 Median $371.54 Typical High $794.33 | Professional | None | $263.03 | $371.54 | $794.33 |
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 $74.13 Median $199.53 Typical High $501.19 | Professional | None | $74.13 | $199.53 | $501.19 |
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 $41.69 Median $66.07 Typical High $169.82 | Professional | 52 · Reduced service | $41.69 | $66.07 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $26.30 Typical High $69.18 | Professional | 53 · Discontinued | $16.60 | $26.30 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $100.00 Typical High $257.04 | Professional | 54 · Surgery only | $61.66 | $100.00 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $19.95 Typical High $51.29 | Professional | 55 · Aftercare only | $12.30 | $19.95 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $13.18 Typical High $33.88 | Professional | 56 · Pre-op care only | $8.32 | $13.18 | $33.88 |
Where Virginia sits
The same service costs 4.2 times more in Washington than in Virginia. 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· 51st of 51
$107
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.