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 $204.17 Median $2,570.40 Typical High $9,332.54 | Facility | None | $204.17 | $2,570.40 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $549.54 Typical High $954.99 | Professional | None | $190.55 | $549.54 | $954.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $3,715.35 Typical High $4,265.80 | Facility | None | $2,884.03 | $3,715.35 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $162.18 Median $549.54 Typical High $891.25 | Professional | None | $162.18 | $549.54 | $891.25 |
CareFirst Setting Professional Modifier None Typical Low $158.49 Median $173.78 Typical High $229.09 | Professional | None | $158.49 | $173.78 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $707.95 Typical High $1,621.81 | Facility | None | $501.19 | $707.95 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $398.11 Typical High $1,023.29 | Professional | None | $158.49 | $398.11 | $1,023.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $1,000.00 | Professional | None | $676.08 | $794.33 | $1,000.00 |
Medcost Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,737.80 | $1,737.80 | $1,737.80 |
Medcost Setting Facility Modifier None Typical Low $190.55 Median $309.03 Typical High $1,174.90 | Facility | None | $190.55 | $309.03 | $1,174.90 |
Medcost Setting Professional Modifier None Typical Low $501.19 Median $660.69 Typical High $758.58 | Professional | None | $501.19 | $660.69 | $758.58 |
Sentara Setting Facility Modifier None Typical Low $147.91 Median $630.96 Typical High $2,951.21 | Facility | None | $147.91 | $630.96 | $2,951.21 |
Sentara Setting Professional Modifier None Typical Low $660.69 Median $776.25 Typical High $1,737.80 | Professional | None | $660.69 | $776.25 | $1,737.80 |
United Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $5,888.44 | Facility | None | $588.84 | $2,187.76 | $5,888.44 |
United Setting Professional Modifier None Typical Low $147.91 Median $512.86 Typical High $1,122.02 | Professional | None | $147.91 | $512.86 | $1,122.02 |
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 $95.50 Median $186.21 Typical High $478.63 | Professional | 52 · Reduced service | $95.50 | $186.21 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $74.13 Typical High $190.55 | Professional | 53 · Discontinued | $38.02 | $74.13 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $281.84 Typical High $707.95 | Professional | 54 · Surgery only | $144.54 | $281.84 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $56.23 Typical High $141.25 | Professional | 55 · Aftercare only | $28.84 | $56.23 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $37.15 Typical High $95.50 | Professional | 56 · Pre-op care only | $19.05 | $37.15 | $95.50 |
Where Virginia sits
The same service costs 5.2 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· 26th of 51
$617
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.