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 $186.21 Median $4,073.80 Typical High $10,000.00 | Facility | None | $186.21 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $549.54 Typical High $758.58 | Professional | None | $177.83 | $549.54 | $758.58 |
Anthem BCBS Setting Professional Modifier None Typical Low $147.91 Median $416.87 Typical High $691.83 | Professional | None | $147.91 | $416.87 | $691.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $218.78 Median $630.96 Typical High $1,023.29 | Professional | 50 · Both sides | $218.78 | $630.96 | $1,023.29 |
CareFirst Setting Professional Modifier None Typical Low $144.54 Median $158.49 Typical High $208.93 | Professional | None | $144.54 | $158.49 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $389.05 Typical High $812.83 | Professional | None | $141.25 | $389.05 | $812.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $501.19 Median $588.84 Typical High $741.31 | Professional | None | $501.19 | $588.84 | $741.31 |
Medcost Setting Professional Modifier None Typical Low $229.09 Median $870.96 Typical High $870.96 | Professional | None | $229.09 | $870.96 | $870.96 |
Medcost Setting Facility Modifier None Typical Low $229.09 Median $288.40 Typical High $954.99 | Facility | None | $229.09 | $288.40 | $954.99 |
Medcost Setting Professional Modifier None Typical Low $199.53 Median $524.81 Typical High $660.69 | Professional | None | $199.53 | $524.81 | $660.69 |
Sentara Setting Facility Modifier None Typical Low $138.04 Median $239.88 Typical High $10,232.93 | Facility | None | $138.04 | $239.88 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $151.36 Median $676.08 Typical High $1,318.26 | Professional | None | $151.36 | $676.08 | $1,318.26 |
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 $141.25 Median $380.19 Typical High $933.25 | Professional | None | $141.25 | $380.19 | $933.25 |
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 $89.13 Median $134.90 Typical High $380.19 | Professional | 52 · Reduced service | $89.13 | $134.90 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $53.70 Typical High $151.36 | Professional | 53 · Discontinued | $35.48 | $53.70 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $204.17 Typical High $562.34 | Professional | 54 · Surgery only | $131.83 | $204.17 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $40.74 Typical High $112.20 | Professional | 55 · Aftercare only | $26.30 | $40.74 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $26.92 Typical High $75.86 | Professional | 56 · Pre-op care only | $17.78 | $26.92 | $75.86 |
Where Virginia sits
The same service costs 3.5 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· 38th of 51
$447
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.