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 $102.33 Median $2,041.74 Typical High $9,332.54 | Facility | None | $102.33 | $2,041.74 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $190.55 Typical High $269.15 | Professional | None | $83.18 | $190.55 | $269.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $67.61 Median $141.25 Typical High $218.78 | Professional | None | $67.61 | $141.25 | $218.78 |
CareFirst Setting Professional Modifier None Typical Low $66.07 Median $74.13 Typical High $87.10 | Professional | None | $66.07 | $74.13 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $147.91 Typical High $302.00 | Professional | None | $67.61 | $147.91 | $302.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $194.98 Typical High $239.88 | Professional | None | $154.88 | $194.98 | $239.88 |
Medcost Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | None | $426.58 | $426.58 | $426.58 |
Medcost Setting Facility Modifier None Typical Low $100.00 Median $134.90 Typical High $354.81 | Facility | None | $100.00 | $134.90 | $354.81 |
Medcost Setting Professional Modifier None Typical Low $158.49 Median $181.97 Typical High $186.21 | Professional | None | $158.49 | $181.97 | $186.21 |
Sentara Setting Facility Modifier None Typical Low $64.57 Median $138.04 Typical High $10,232.93 | Facility | None | $64.57 | $138.04 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $204.17 Median $257.04 Typical High $436.52 | Professional | None | $204.17 | $257.04 | $436.52 |
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 $67.61 Median $154.88 Typical High $354.81 | Professional | None | $67.61 | $154.88 | $354.81 |
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 $41.69 Median $63.10 Typical High $112.20 | Professional | 52 · Reduced service | $41.69 | $63.10 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $25.12 Typical High $44.67 | Professional | 53 · Discontinued | $16.60 | $25.12 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $95.50 Typical High $169.82 | Professional | 54 · Surgery only | $61.66 | $95.50 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $19.05 Typical High $33.88 | Professional | 55 · Aftercare only | $12.59 | $19.05 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $12.59 Typical High $22.39 | Professional | 56 · Pre-op care only | $8.32 | $12.59 | $22.39 |
Where Virginia sits
The same service costs 2.7 times more in Wisconsin than in Utah. 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· 41st of 51
$158
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.