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 $309.03 Median $4,365.16 Typical High $10,000.00 | Facility | None | $309.03 | $4,365.16 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $302.00 Typical High $346.74 | Professional | None | $151.36 | $302.00 | $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 $131.83 Median $229.09 Typical High $354.81 | Professional | None | $131.83 | $229.09 | $354.81 |
CareFirst Setting Professional Modifier None Typical Low $131.83 Median $144.54 Typical High $1,659.59 | Professional | None | $131.83 | $144.54 | $1,659.59 |
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 $323.59 Typical High $407.38 | Professional | None | $114.82 | $323.59 | $407.38 |
Medcost Setting Professional Modifier None Typical Low $309.03 Median $389.05 Typical High $389.05 | Professional | None | $309.03 | $389.05 | $389.05 |
Medcost Setting Facility Modifier None Typical Low $151.36 Median $245.47 Typical High $501.19 | Facility | None | $151.36 | $245.47 | $501.19 |
Medcost Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
Sentara Setting Facility Modifier None Typical Low $138.04 Median $371.54 Typical High $2,454.71 | Facility | None | $138.04 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $229.09 Median $346.74 Typical High $1,174.90 | Professional | None | $229.09 | $346.74 | $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 $239.88 Typical High $489.78 | Professional | None | $117.49 | $239.88 | $489.78 |
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 $95.50 Typical High $173.78 | Professional | 52 · Reduced service | $75.86 | $95.50 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $38.90 Typical High $69.18 | Professional | 53 · Discontinued | $30.20 | $38.90 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $144.54 Typical High $257.04 | Professional | 54 · Surgery only | $112.20 | $144.54 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $28.84 Typical High $51.29 | Professional | 55 · Aftercare only | $22.39 | $28.84 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $19.50 Typical High $34.67 | Professional | 56 · Pre-op care only | $15.14 | $19.50 | $34.67 |
Where Virginia sits
The same service costs 3.1 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· 34th of 51
$263
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.