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 $263.03 Median $4,786.30 Typical High $10,000.00 | Facility | None | $263.03 | $4,786.30 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $263.03 Typical High $263.03 | Professional | None | $257.04 | $263.03 | $263.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,000.00 Median $3,630.78 Typical High $4,168.69 | Facility | None | $1,000.00 | $3,630.78 | $4,168.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $208.93 Median $251.19 Typical High $295.12 | Professional | None | $208.93 | $251.19 | $295.12 |
CareFirst Setting Professional Modifier None Typical Low $218.78 Median $245.47 Typical High $288.40 | Professional | None | $218.78 | $245.47 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $812.83 Typical High $3,090.30 | Facility | None | $588.84 | $812.83 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $234.42 Typical High $338.84 | Professional | None | $218.78 | $234.42 | $338.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $194.98 Median $218.78 Typical High $316.23 | Professional | None | $194.98 | $218.78 | $316.23 |
Medcost Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
Medcost Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $426.58 | Facility | None | $263.03 | $263.03 | $426.58 |
Medcost Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $338.84 | Professional | None | $331.13 | $331.13 | $338.84 |
Sentara Setting Facility Modifier None Typical Low $245.47 Median $1,071.52 Typical High $3,715.35 | Facility | None | $245.47 | $1,071.52 | $3,715.35 |
Sentara Setting Professional Modifier None Typical Low $229.09 Median $269.15 Typical High $457.09 | Professional | None | $229.09 | $269.15 | $457.09 |
United Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $5,888.44 | Facility | None | $588.84 | $2,187.76 | $5,888.44 |
United Setting Professional Modifier None Typical Low $190.55 Median $229.09 Typical High $407.38 | Professional | None | $190.55 | $229.09 | $407.38 |
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 $128.82 Median $128.82 Typical High $131.83 | Professional | 52 · Reduced service | $128.82 | $128.82 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | 53 · Discontinued | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $194.98 Typical High $199.53 | Professional | 54 · Surgery only | $194.98 | $194.98 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $39.81 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $25.70 Typical High $26.30 | Professional | 56 · Pre-op care only | $25.70 | $25.70 | $26.30 |
Where Virginia sits
The same service costs 4.7 times more in Wyoming 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· 39th of 51
$251
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.