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 $18.20 Median $33.88 Typical High $69.18 | Facility | None | $18.20 | $33.88 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $17.78 Median $27.54 Typical High $35.48 | Professional | None | $17.78 | $27.54 | $35.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,754.40 Median $8,317.64 Typical High $11,481.54 | Facility | None | $5,754.40 | $8,317.64 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.47 Median $19.05 Typical High $33.11 | Professional | None | $10.47 | $19.05 | $33.11 |
CareFirst Setting Professional Modifier None Typical Low $14.13 Median $15.49 Typical High $776.25 | Professional | None | $14.13 | $15.49 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $1,230.27 | Facility | None | $50.12 | $50.12 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $14.79 Median $27.54 Typical High $45.71 | Professional | None | $14.79 | $27.54 | $45.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $12.88 Median $32.36 Typical High $39.81 | Professional | None | $12.88 | $32.36 | $39.81 |
Medcost Setting Professional Modifier None Typical Low $39.81 Median $48.98 Typical High $48.98 | Professional | None | $39.81 | $48.98 | $48.98 |
Medcost Setting Facility Modifier None Typical Low $14.13 Median $21.88 Typical High $41.69 | Facility | None | $14.13 | $21.88 | $41.69 |
Medcost Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | None | $38.90 | $38.90 | $38.90 |
Sentara Setting Facility Modifier None Typical Low $14.45 Median $36.31 Typical High $1,737.80 | Facility | None | $14.45 | $36.31 | $1,737.80 |
Sentara Setting Professional Modifier None Typical Low $26.30 Median $39.81 Typical High $1,174.90 | Professional | None | $26.30 | $39.81 | $1,174.90 |
United Setting Facility Modifier None Typical Low $100.00 Median $660.69 Typical High $10,715.19 | Facility | None | $100.00 | $660.69 | $10,715.19 |
United Setting Professional Modifier None Typical Low $15.14 Median $28.18 Typical High $53.70 | Professional | None | $15.14 | $28.18 | $53.70 |
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 $8.91 Median $12.88 Typical High $17.78 | Professional | 52 · Reduced service | $8.91 | $12.88 | $17.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.55 Median $5.25 Typical High $7.08 | Professional | 53 · Discontinued | $3.55 | $5.25 | $7.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $13.18 Median $19.50 Typical High $26.92 | Professional | 54 · Surgery only | $13.18 | $19.50 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.63 Median $3.89 Typical High $5.37 | Professional | 55 · Aftercare only | $2.63 | $3.89 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.78 Median $2.57 Typical High $3.55 | Professional | 56 · Pre-op care only | $1.78 | $2.57 | $3.55 |
Where Virginia sits
The same service costs 3.5 times more in Wisconsin than in Kentucky. 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· 50th of 51
$26.30
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.