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 $151.36 Median $4,365.16 Typical High $10,000.00 | Facility | None | $151.36 | $4,365.16 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $549.54 Typical High $758.58 | Professional | None | $141.25 | $549.54 | $758.58 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $416.87 Typical High $707.95 | Professional | None | $117.49 | $416.87 | $707.95 |
CareFirst Setting Professional Modifier None Typical Low $114.82 Median $128.82 Typical High $165.96 | Professional | None | $114.82 | $128.82 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $407.38 Typical High $831.76 | Professional | None | $117.49 | $407.38 | $831.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $794.33 | Professional | None | $537.03 | $630.96 | $794.33 |
Medcost Setting Professional Modifier None Typical Low $190.55 Median $912.01 Typical High $912.01 | Professional | None | $190.55 | $912.01 | $912.01 |
Medcost Setting Facility Modifier None Typical Low $194.98 Median $229.09 Typical High $933.25 | Facility | None | $194.98 | $229.09 | $933.25 |
Medcost Setting Professional Modifier None Typical Low $169.82 Median $524.81 Typical High $660.69 | Professional | None | $169.82 | $524.81 | $660.69 |
Sentara Setting Facility Modifier None Typical Low $109.65 Median $194.98 Typical High $10,232.93 | Facility | None | $109.65 | $194.98 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $125.89 Median $676.08 Typical High $1,348.96 | Professional | None | $125.89 | $676.08 | $1,348.96 |
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 $117.49 Median $346.74 Typical High $977.24 | Professional | None | $117.49 | $346.74 | $977.24 |
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 $70.79 Median $112.20 Typical High $380.19 | Professional | 52 · Reduced service | $70.79 | $112.20 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $44.67 Typical High $151.36 | Professional | 53 · Discontinued | $28.18 | $44.67 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $165.96 Typical High $562.34 | Professional | 54 · Surgery only | $104.71 | $165.96 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $33.11 Typical High $114.82 | Professional | 55 · Aftercare only | $20.89 | $33.11 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $22.39 Typical High $75.86 | Professional | 56 · Pre-op care only | $14.13 | $22.39 | $75.86 |
Where Virginia sits
The same service costs 4.0 times more in Wisconsin than in Maryland. 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
$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.