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 $44.67 Median $239.88 Typical High $8,317.64 | Facility | None | $44.67 | $239.88 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $34.67 Median $107.15 Typical High $208.93 | Professional | None | $34.67 | $107.15 | $208.93 |
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 $29.51 Median $79.43 Typical High $128.82 | Professional | None | $29.51 | $79.43 | $128.82 |
CareFirst Setting Professional Modifier None Typical Low $30.20 Median $33.88 Typical High $676.08 | Professional | None | $30.20 | $33.88 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $100.00 Typical High $199.53 | Facility | None | $50.12 | $100.00 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $83.18 Typical High $151.36 | Professional | None | $30.90 | $83.18 | $151.36 |
Kaiser Permanente Setting Professional Modifier None Typical Low $27.54 Median $120.23 Typical High $147.91 | Professional | None | $27.54 | $120.23 | $147.91 |
Medcost Setting Professional Modifier None Typical Low $97.72 Median $123.03 Typical High $123.03 | Professional | None | $97.72 | $123.03 | $123.03 |
Medcost Setting Facility Modifier None Typical Low $36.31 Median $58.88 Typical High $186.21 | Facility | None | $36.31 | $58.88 | $186.21 |
Medcost Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
Sentara Setting Facility Modifier None Typical Low $30.20 Median $371.54 Typical High $2,454.71 | Facility | None | $30.20 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $69.18 Median $147.91 Typical High $870.96 | Professional | None | $69.18 | $147.91 | $870.96 |
United Setting Facility Modifier None Typical Low $100.00 Median $660.69 Typical High $2,089.30 | Facility | None | $100.00 | $660.69 | $2,089.30 |
United Setting Professional Modifier None Typical Low $27.54 Median $72.44 Typical High $177.83 | Professional | None | $27.54 | $72.44 | $177.83 |
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 $17.38 Median $28.84 Typical High $61.66 | Professional | 52 · Reduced service | $17.38 | $28.84 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $11.48 Typical High $24.55 | Professional | 53 · Discontinued | $6.92 | $11.48 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $25.70 Median $42.66 Typical High $93.33 | Professional | 54 · Surgery only | $25.70 | $42.66 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $13.49 Typical High $18.62 | Professional | 55 · Aftercare only | $5.13 | $13.49 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $5.75 Typical High $12.30 | Professional | 56 · Pre-op care only | $3.47 | $5.75 | $12.30 |
Where Virginia sits
The same service costs 5.4 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· 41st of 51
$93.33
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.