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 $10.47 Median $20.89 Typical High $57.54 | Facility | None | $10.47 | $20.89 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $10.47 Median $21.88 Typical High $48.98 | Professional | None | $10.47 | $21.88 | $48.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.91 Median $28.84 Typical High $39.81 | Professional | None | $8.91 | $28.84 | $39.81 |
CareFirst Setting Professional Modifier None Typical Low $8.71 Median $9.55 Typical High $891.25 | Professional | None | $8.71 | $9.55 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,230.27 Typical High $2,691.53 | Facility | None | $512.86 | $1,230.27 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $8.71 Median $25.70 Typical High $46.77 | Professional | None | $8.71 | $25.70 | $46.77 |
Kaiser Permanente Setting Professional Modifier None Typical Low $7.76 Median $37.15 Typical High $45.71 | Professional | None | $7.76 | $37.15 | $45.71 |
Medcost Setting Professional Modifier None Typical Low $34.67 Median $43.65 Typical High $43.65 | Professional | None | $34.67 | $43.65 | $43.65 |
Medcost Setting Facility Modifier None Typical Low $10.47 Median $17.38 Typical High $48.98 | Facility | None | $10.47 | $17.38 | $48.98 |
Medcost Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Sentara Setting Facility Modifier None Typical Low $8.91 Median $141.25 Typical High $2,454.71 | Facility | None | $8.91 | $141.25 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $27.54 Median $36.31 Typical High $1,479.11 | Professional | None | $27.54 | $36.31 | $1,479.11 |
United Setting Facility Modifier None Typical Low $100.00 Median $660.69 Typical High $2,089.30 | Facility | None | $100.00 | $660.69 | $2,089.30 |
United Setting Professional Modifier None Typical Low $8.91 Median $21.38 Typical High $50.12 | Professional | None | $8.91 | $21.38 | $50.12 |
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 $5.25 Median $9.12 Typical High $20.42 | Professional | 52 · Reduced service | $5.25 | $9.12 | $20.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.14 Median $3.63 Typical High $8.13 | Professional | 53 · Discontinued | $2.14 | $3.63 | $8.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $7.94 Median $13.49 Typical High $30.20 | Professional | 54 · Surgery only | $7.94 | $13.49 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.58 Median $2.69 Typical High $6.03 | Professional | 55 · Aftercare only | $1.58 | $2.69 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.07 Median $1.82 Typical High $4.07 | Professional | 56 · Pre-op care only | $1.07 | $1.82 | $4.07 |
Where Virginia sits
The same service costs 4.2 times more in Wisconsin than in Nebraska. 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· 31st of 51
$30.20
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.