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 $4,073.80 Typical High $10,000.00 | Facility | None | $72.44 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $144.54 Typical High $190.55 | Professional | None | $69.18 | $144.54 | $190.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $58.88 Median $123.03 Typical High $199.53 | Professional | None | $58.88 | $123.03 | $199.53 |
CareFirst Setting Professional Modifier None Typical Low $58.88 Median $64.57 Typical High $85.11 | Professional | None | $58.88 | $64.57 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $128.82 Typical High $229.09 | Professional | None | $61.66 | $128.82 | $229.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $144.54 Median $169.82 Typical High $213.80 | Professional | None | $144.54 | $169.82 | $213.80 |
Medcost Setting Professional Modifier None Typical Low $208.93 Median $263.03 Typical High $758.58 | Professional | None | $208.93 | $263.03 | $758.58 |
Medcost Setting Facility Modifier None Typical Low $93.33 Median $117.49 Typical High $269.15 | Facility | None | $93.33 | $117.49 | $269.15 |
Medcost Setting Professional Modifier None Typical Low $52.48 Median $147.91 Typical High $177.83 | Professional | None | $52.48 | $147.91 | $177.83 |
Sentara Setting Facility Modifier None Typical Low $56.23 Median $120.23 Typical High $10,232.93 | Facility | None | $56.23 | $120.23 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $147.91 Median $208.93 Typical High $588.84 | Professional | None | $147.91 | $208.93 | $588.84 |
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 $56.23 Median $125.89 Typical High $281.84 | Professional | None | $56.23 | $125.89 | $281.84 |
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 $34.67 Median $56.23 Typical High $95.50 | Professional | 52 · Reduced service | $34.67 | $56.23 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $22.39 Typical High $38.02 | Professional | 53 · Discontinued | $13.80 | $22.39 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $83.18 Typical High $141.25 | Professional | 54 · Surgery only | $52.48 | $83.18 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $16.60 Typical High $28.18 | Professional | 55 · Aftercare only | $10.47 | $16.60 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $11.22 Typical High $19.05 | Professional | 56 · Pre-op care only | $6.92 | $11.22 | $19.05 |
Where Virginia sits
The same service costs 3.7 times more in Wisconsin than in Maryland. 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· 36th of 51
$138
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.