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 $281.84 Median $5,495.41 Typical High $14,125.38 | Facility | None | $281.84 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $281.84 Typical High $630.96 | Professional | None | $269.15 | $281.84 | $630.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $3,715.35 Typical High $4,265.80 | Facility | None | $2,884.03 | $3,715.35 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $213.80 Median $257.04 Typical High $323.59 | Professional | None | $213.80 | $257.04 | $323.59 |
CareFirst Setting Professional Modifier None Typical Low $223.87 Median $251.19 Typical High $309.03 | Professional | None | $223.87 | $251.19 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $794.33 Typical High $5,495.41 | Facility | None | $501.19 | $794.33 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $309.03 Typical High $426.58 | Professional | None | $213.80 | $309.03 | $426.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $204.17 Median $245.47 Typical High $302.00 | Professional | None | $204.17 | $245.47 | $302.00 |
Medcost Setting Facility Modifier None Typical Low $269.15 Median $338.84 Typical High $436.52 | Facility | None | $269.15 | $338.84 | $436.52 |
Medcost Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
Sentara Setting Facility Modifier None Typical Low $245.47 Median $912.01 Typical High $5,128.61 | Facility | None | $245.47 | $912.01 | $5,128.61 |
Sentara Setting Professional Modifier None Typical Low $245.47 Median $331.13 Typical High $2,187.76 | Professional | None | $245.47 | $331.13 | $2,187.76 |
United Setting Facility Modifier None Typical Low $436.52 Median $2,344.23 Typical High $6,309.57 | Facility | None | $436.52 | $2,344.23 | $6,309.57 |
United Setting Professional Modifier None Typical Low $213.80 Median $354.81 Typical High $524.81 | Professional | None | $213.80 | $354.81 | $524.81 |
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 $131.83 Median $131.83 Typical High $141.25 | Professional | 52 · Reduced service | $131.83 | $131.83 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $57.54 | Professional | 53 · Discontinued | $53.70 | $53.70 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $199.53 Typical High $213.80 | Professional | 54 · Surgery only | $199.53 | $199.53 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $39.81 Typical High $42.66 | Professional | 55 · Aftercare only | $39.81 | $39.81 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $28.18 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $28.18 |
Where Virginia sits
The same service costs 4.0 times more in Wisconsin than in New York. 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· 48th of 51
$288
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.