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 $47.86 Median $47.86 Typical High $56.23 | Facility | None | $47.86 | $47.86 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $56.23 Typical High $56.23 | Professional | None | $46.77 | $56.23 | $56.23 |
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 $43.65 Median $52.48 Typical High $64.57 | Professional | None | $43.65 | $52.48 | $64.57 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $66.07 Median $77.62 Typical High $100.00 | Professional | 50 · Both sides | $66.07 | $77.62 | $100.00 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $27.54 Median $33.11 Typical High $46.77 | Professional | 62 · Two surgeons | $27.54 | $33.11 | $46.77 |
CareFirst Setting Professional Modifier None Typical Low $50.12 Median $54.95 Typical High $1,513.56 | Professional | None | $50.12 | $54.95 | $1,513.56 |
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 $45.71 Median $54.95 Typical High $89.13 | Professional | None | $45.71 | $54.95 | $89.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $39.81 Median $45.71 Typical High $58.88 | Professional | None | $39.81 | $45.71 | $58.88 |
Medcost Setting Professional Modifier None Typical Low $72.44 Median $91.20 Typical High $91.20 | Professional | None | $72.44 | $91.20 | $91.20 |
Medcost Setting Facility Modifier None Typical Low $56.23 Median $74.13 Typical High $91.20 | Facility | None | $56.23 | $74.13 | $91.20 |
Medcost Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
Sentara Setting Facility Modifier None Typical Low $48.98 Median $371.54 Typical High $2,570.40 | Facility | None | $48.98 | $371.54 | $2,570.40 |
Sentara Setting Professional Modifier None Typical Low $47.86 Median $66.07 Typical High $1,071.52 | Professional | None | $47.86 | $66.07 | $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 $39.81 Median $64.57 Typical High $97.72 | Professional | None | $39.81 | $64.57 | $97.72 |
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 $23.44 Median $28.18 Typical High $28.18 | Professional | 52 · Reduced service | $23.44 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $11.22 Typical High $11.22 | Professional | 53 · Discontinued | $9.33 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $8.32 Typical High $8.32 | Professional | 55 · Aftercare only | $7.08 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $5.62 Typical High $5.62 | Professional | 56 · Pre-op care only | $4.68 | $5.62 | $5.62 |
Where Virginia sits
The same service costs 4.7 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
$56.23
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.