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 $58.88 Median $3,801.89 Typical High $9,332.54 | Facility | None | $58.88 | $3,801.89 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $125.89 Typical High $251.19 | Professional | None | $56.23 | $125.89 | $251.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $45.71 Median $95.50 Typical High $151.36 | Professional | None | $45.71 | $95.50 | $151.36 |
CareFirst Setting Professional Modifier None Typical Low $47.86 Median $52.48 Typical High $72.44 | Professional | None | $47.86 | $52.48 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $104.71 Typical High $239.88 | Professional | None | $45.71 | $104.71 | $239.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $109.65 Median $128.82 Typical High $162.18 | Professional | None | $109.65 | $128.82 | $162.18 |
Medcost Setting Professional Modifier None Typical Low $74.13 Median $288.40 Typical High $288.40 | Professional | None | $74.13 | $288.40 | $288.40 |
Medcost Setting Facility Modifier None Typical Low $75.86 Median $91.20 Typical High $263.03 | Facility | None | $75.86 | $91.20 | $263.03 |
Medcost Setting Professional Modifier None Typical Low $54.95 Median $109.65 Typical High $204.17 | Professional | None | $54.95 | $109.65 | $204.17 |
Sentara Setting Facility Modifier None Typical Low $43.65 Median $75.86 Typical High $10,232.93 | Facility | None | $43.65 | $75.86 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $50.12 Median $186.21 Typical High $354.81 | Professional | None | $50.12 | $186.21 | $354.81 |
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 $46.77 Median $112.20 Typical High $269.15 | Professional | None | $46.77 | $112.20 | $269.15 |
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 $28.18 Median $43.65 Typical High $81.28 | Professional | 52 · Reduced service | $28.18 | $43.65 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $17.38 Typical High $32.36 | Professional | 53 · Discontinued | $11.22 | $17.38 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $66.07 Typical High $120.23 | Professional | 54 · Surgery only | $41.69 | $66.07 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $13.18 Typical High $23.99 | Professional | 55 · Aftercare only | $8.32 | $13.18 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $8.71 Typical High $16.22 | Professional | 56 · Pre-op care only | $5.62 | $8.71 | $16.22 |
Where Virginia sits
The same service costs 2.8 times more in Wisconsin than in Florida. 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· 43rd of 51
$107
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.