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 $64.57 Median $4,365.16 Typical High $14,125.38 | Facility | None | $64.57 | $4,365.16 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $91.20 Typical High $125.89 | Professional | None | $60.26 | $91.20 | $125.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $51.29 Median $79.43 Typical High $112.20 | Professional | None | $51.29 | $79.43 | $112.20 |
CareFirst Setting Professional Modifier None Typical Low $52.48 Median $57.54 Typical High $891.25 | Professional | None | $52.48 | $57.54 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,230.27 Typical High $2,691.53 | Facility | None | $512.86 | $1,230.27 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $87.10 Typical High $194.98 | Professional | None | $52.48 | $87.10 | $194.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $44.67 Median $102.33 Typical High $125.89 | Professional | None | $44.67 | $102.33 | $125.89 |
Medcost Setting Professional Modifier None Typical Low $234.42 Median $288.40 Typical High $288.40 | Professional | None | $234.42 | $288.40 | $288.40 |
Medcost Setting Facility Modifier None Typical Low $60.26 Median $91.20 Typical High $151.36 | Facility | None | $60.26 | $91.20 | $151.36 |
Medcost Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
Sentara Setting Facility Modifier None Typical Low $54.95 Median $302.00 Typical High $2,454.71 | Facility | None | $54.95 | $302.00 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $70.79 Median $131.83 Typical High $1,258.93 | Professional | None | $70.79 | $131.83 | $1,258.93 |
United Setting Facility Modifier None Typical Low $100.00 Median $660.69 Typical High $2,089.30 | Facility | None | $100.00 | $660.69 | $2,089.30 |
United Setting Professional Modifier None Typical Low $53.70 Median $97.72 Typical High $186.21 | Professional | None | $53.70 | $97.72 | $186.21 |
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 $30.20 Median $41.69 Typical High $54.95 | Professional | 52 · Reduced service | $30.20 | $41.69 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $16.60 Typical High $21.88 | Professional | 53 · Discontinued | $12.02 | $16.60 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $63.10 Typical High $83.18 | Professional | 54 · Surgery only | $45.71 | $63.10 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $12.59 Typical High $16.60 | Professional | 55 · Aftercare only | $9.12 | $12.59 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $8.32 Typical High $10.96 | Professional | 56 · Pre-op care only | $6.03 | $8.32 | $10.96 |
Where Virginia sits
The same service costs 3.7 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
$91.20
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.