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 $4,073.80 Typical High $10,000.00 | Facility | None | $309.03 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $1,202.26 Typical High $1,698.24 | Professional | None | $275.42 | $1,202.26 | $1,698.24 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $1,023.29 Typical High $1,698.24 | Professional | None | $245.47 | $1,023.29 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $363.08 Median $1,548.82 Typical High $2,511.89 | Professional | 50 · Both sides | $363.08 | $1,548.82 | $2,511.89 |
CareFirst Setting Professional Modifier None Typical Low $239.88 Median $269.15 Typical High $316.23 | Professional | None | $239.88 | $269.15 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $676.08 Typical High $1,995.26 | Professional | None | $234.42 | $676.08 | $1,995.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,513.56 Median $1,778.28 Typical High $2,238.72 | Professional | None | $1,513.56 | $1,778.28 | $2,238.72 |
Medcost Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Professional | None | $3,162.28 | $3,162.28 | $3,162.28 |
Medcost Setting Facility Modifier None Typical Low $295.12 Median $446.68 Typical High $2,398.83 | Facility | None | $295.12 | $446.68 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $1,174.90 Median $1,548.82 Typical High $1,949.84 | Professional | None | $1,174.90 | $1,548.82 | $1,949.84 |
Sentara Setting Facility Modifier None Typical Low $213.80 Median $457.09 Typical High $10,232.93 | Facility | None | $213.80 | $457.09 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1,258.93 Median $1,513.56 Typical High $3,019.95 | Professional | None | $1,258.93 | $1,513.56 | $3,019.95 |
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 $229.09 Median $1,023.29 Typical High $2,290.87 | Professional | None | $229.09 | $1,023.29 | $2,290.87 |
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 $138.04 Median $218.78 Typical High $851.14 | Professional | 52 · Reduced service | $138.04 | $218.78 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $87.10 Typical High $338.84 | Professional | 53 · Discontinued | $54.95 | $87.10 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $331.13 Typical High $1,288.25 | Professional | 54 · Surgery only | $204.17 | $331.13 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $66.07 Typical High $257.04 | Professional | 55 · Aftercare only | $40.74 | $66.07 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $43.65 Typical High $169.82 | Professional | 56 · Pre-op care only | $27.54 | $43.65 | $169.82 |
Where Virginia sits
The same service costs 6.5 times more in Washington 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· 35th of 51
$1,072
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.