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 $501.19 Median $3,981.07 Typical High $9,332.54 | Facility | None | $501.19 | $3,981.07 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $2,041.74 Typical High $2,754.23 | Professional | None | $407.38 | $2,041.74 | $2,754.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $7,413.10 Typical High $9,549.93 | Facility | None | $6,165.95 | $7,413.10 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $338.84 Median $1,548.82 Typical High $2,570.40 | Professional | None | $338.84 | $1,548.82 | $2,570.40 |
CareFirst Setting Professional Modifier None Typical Low $331.13 Median $363.08 Typical High $478.63 | Professional | None | $331.13 | $363.08 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $831.76 Typical High $3,311.31 | Professional | None | $338.84 | $831.76 | $3,311.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,862.09 Median $2,187.76 Typical High $2,754.23 | Professional | None | $1,862.09 | $2,187.76 | $2,754.23 |
Medcost Setting Professional Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $5,248.07 | Professional | None | $5,248.07 | $5,248.07 | $5,248.07 |
Medcost Setting Facility Modifier None Typical Low $537.03 Median $660.69 Typical High $3,981.07 | Facility | None | $537.03 | $660.69 | $3,981.07 |
Medcost Setting Professional Modifier None Typical Low $1,862.09 Median $2,951.21 Typical High $4,677.35 | Professional | None | $1,862.09 | $2,951.21 | $4,677.35 |
Sentara Setting Facility Modifier None Typical Low $316.23 Median $676.08 Typical High $12,022.64 | Facility | None | $316.23 | $676.08 | $12,022.64 |
Sentara Setting Professional Modifier None Typical Low $2,187.76 Median $2,818.38 Typical High $5,495.41 | Professional | None | $2,187.76 | $2,818.38 | $5,495.41 |
United Setting Facility Modifier None Typical Low $9,549.93 Median $13,182.57 Typical High $30,902.95 | Facility | None | $9,549.93 | $13,182.57 | $30,902.95 |
United Setting Professional Modifier None Typical Low $346.74 Median $1,659.59 Typical High $3,981.07 | Professional | None | $346.74 | $1,659.59 | $3,981.07 |
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 $204.17 Median $323.59 Typical High $1,348.96 | Professional | 52 · Reduced service | $204.17 | $323.59 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $128.82 Typical High $549.54 | Professional | 53 · Discontinued | $81.28 | $128.82 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $478.63 Typical High $2,041.74 | Professional | 54 · Surgery only | $302.00 | $478.63 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $95.50 Typical High $407.38 | Professional | 55 · Aftercare only | $61.66 | $95.50 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $64.57 Typical High $275.42 | Professional | 56 · Pre-op care only | $40.74 | $64.57 | $275.42 |
Where Virginia sits
The same service costs 6.9 times more in Wisconsin than in Hawaii. 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· 34th of 51
$1,820
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.