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 $72.44 Median $72.44 Typical High $85.11 | Facility | None | $72.44 | $72.44 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $85.11 Typical High $85.11 | Professional | None | $70.79 | $85.11 | $85.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $2,398.83 Typical High $2,951.21 | Facility | None | $1,698.24 | $2,398.83 | $2,951.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $66.07 Median $79.43 Typical High $100.00 | Professional | None | $66.07 | $79.43 | $100.00 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $100.00 Median $117.49 Typical High $151.36 | Professional | 50 · Both sides | $100.00 | $117.49 | $151.36 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $41.69 Median $50.12 Typical High $64.57 | Professional | 62 · Two surgeons | $41.69 | $50.12 | $64.57 |
CareFirst Setting Professional Modifier None Typical Low $75.86 Median $85.11 Typical High $2,238.72 | Professional | None | $75.86 | $85.11 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $645.65 Typical High $1,659.59 | Facility | None | $331.13 | $645.65 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $79.43 Typical High $128.82 | Professional | None | $69.18 | $79.43 | $128.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $60.26 Median $69.18 Typical High $89.13 | Professional | None | $60.26 | $69.18 | $89.13 |
Medcost Setting Professional Modifier None Typical Low $109.65 Median $138.04 Typical High $138.04 | Professional | None | $109.65 | $138.04 | $138.04 |
Medcost Setting Facility Modifier None Typical Low $85.11 Median $112.20 Typical High $138.04 | Facility | None | $85.11 | $112.20 | $138.04 |
Medcost Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
Sentara Setting Facility Modifier None Typical Low $61.66 Median $371.54 Typical High $2,570.40 | Facility | None | $61.66 | $371.54 | $2,570.40 |
Sentara Setting Professional Modifier None Typical Low $70.79 Median $97.72 Typical High $1,071.52 | Professional | None | $70.79 | $97.72 | $1,071.52 |
United Setting Facility Modifier None Typical Low $100.00 Median $660.69 Typical High $2,041.74 | Facility | None | $100.00 | $660.69 | $2,041.74 |
United Setting Professional Modifier None Typical Low $60.26 Median $97.72 Typical High $147.91 | Professional | None | $60.26 | $97.72 | $147.91 |
4 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 $34.67 Median $42.66 Typical High $42.66 | Professional | 52 · Reduced service | $34.67 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $16.98 Typical High $16.98 | Professional | 53 · Discontinued | $14.13 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $12.59 Typical High $12.59 | Professional | 55 · Aftercare only | $10.47 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $8.51 Typical High $8.51 | Professional | 56 · Pre-op care only | $7.08 | $8.51 | $8.51 |
Where Virginia sits
The same service costs 4.5 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· 41st of 51
$85.11
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.