How much rates vary
Facilitymedian $692 · 10th to 90th $145 to $4,786Professionalmedian $251 · 10th to 90th $135 to $398
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 $288.40 Median $4,365.16 Typical High $10,000.00 | Facility | None | $288.40 | $4,365.16 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $288.40 Typical High $346.74 | Professional | None | $151.36 | $288.40 | $346.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $2,398.83 Typical High $2,951.21 | Facility | None | $1,698.24 | $2,398.83 | $2,951.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $239.88 Typical High $354.81 | Professional | None | $134.90 | $239.88 | $354.81 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $199.53 Median $346.74 Typical High $537.03 | Professional | 50 · Both sides | $199.53 | $346.74 | $537.03 |
CareFirst Setting Professional Modifier None Typical Low $125.89 Median $138.04 Typical High $776.25 | Professional | None | $125.89 | $138.04 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $446.68 Typical High $2,187.76 | Facility | None | $218.78 | $446.68 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $257.04 Typical High $416.87 | Professional | None | $134.90 | $257.04 | $416.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $114.82 Median $316.23 Typical High $398.11 | Professional | None | $114.82 | $316.23 | $398.11 |
Medcost Setting Professional Modifier None Typical Low $316.23 Median $398.11 Typical High $398.11 | Professional | None | $316.23 | $398.11 | $398.11 |
Medcost Setting Facility Modifier None Typical Low $151.36 Median $245.47 Typical High $478.63 | Facility | None | $151.36 | $245.47 | $478.63 |
Medcost Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
Sentara Setting Facility Modifier None Typical Low $141.25 Median $371.54 Typical High $2,454.71 | Facility | None | $141.25 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $223.87 Median $338.84 Typical High $1,174.90 | Professional | None | $223.87 | $338.84 | $1,174.90 |
United Setting Facility Modifier None Typical Low $100.00 Median $660.69 Typical High $2,041.74 | Facility | None | $100.00 | $660.69 | $2,041.74 |
United Setting Professional Modifier None Typical Low $117.49 Median $234.42 Typical High $457.09 | Professional | None | $117.49 | $234.42 | $457.09 |
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 $75.86 Median $104.71 Typical High $169.82 | Professional | 52 · Reduced service | $75.86 | $104.71 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $42.66 Typical High $69.18 | Professional | 53 · Discontinued | $30.20 | $42.66 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $158.49 Typical High $257.04 | Professional | 54 · Surgery only | $114.82 | $158.49 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $31.62 Typical High $51.29 | Professional | 55 · Aftercare only | $22.91 | $31.62 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $21.38 Typical High $33.88 | Professional | 56 · Pre-op care only | $15.14 | $21.38 | $33.88 |
Where Virginia sits
The same service costs 3.2 times more in Wisconsin than in Kentucky. 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· 39th of 51
$263
WI $646KY $204
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.