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 $4,073.80 Typical High $10,000.00 | Facility | None | $47.86 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $144.54 Typical High $204.17 | Professional | None | $45.71 | $144.54 | $204.17 |
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 $38.90 Median $123.03 Typical High $194.98 | Professional | None | $38.90 | $123.03 | $194.98 |
CareFirst Setting Professional Modifier None Typical Low $46.77 Median $52.48 Typical High $60.26 | Professional | None | $46.77 | $52.48 | $60.26 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $1,230.27 | Facility | None | $50.12 | $50.12 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $109.65 Typical High $186.21 | Professional | None | $39.81 | $109.65 | $186.21 |
Kaiser Permanente Setting Professional Modifier None Typical Low $165.96 Median $194.98 Typical High $263.03 | Professional | None | $165.96 | $194.98 | $263.03 |
Medcost Setting Professional Modifier None Typical Low $75.86 Median $147.91 Typical High $147.91 | Professional | None | $75.86 | $147.91 | $147.91 |
Medcost Setting Facility Modifier None Typical Low $45.71 Median $74.13 Typical High $281.84 | Facility | None | $45.71 | $74.13 | $281.84 |
Medcost Setting Professional Modifier None Typical Low $63.10 Median $72.44 Typical High $158.49 | Professional | None | $63.10 | $72.44 | $158.49 |
Sentara Setting Facility Modifier None Typical Low $35.48 Median $281.84 Typical High $2,951.21 | Facility | None | $35.48 | $281.84 | $2,951.21 |
Sentara Setting Professional Modifier None Typical Low $52.48 Median $169.82 Typical High $263.03 | Professional | None | $52.48 | $169.82 | $263.03 |
United Setting Facility Modifier None Typical Low $323.59 Median $1,445.44 Typical High $3,630.78 | Facility | None | $323.59 | $1,445.44 | $3,630.78 |
United Setting Professional Modifier None Typical Low $33.11 Median $87.10 Typical High $194.98 | Professional | None | $33.11 | $87.10 | $194.98 |
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 $22.91 Median $40.74 Typical High $102.33 | Professional | 52 · Reduced service | $22.91 | $40.74 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $16.22 Typical High $40.74 | Professional | 53 · Discontinued | $9.12 | $16.22 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $61.66 Typical High $151.36 | Professional | 54 · Surgery only | $33.88 | $61.66 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $12.30 Typical High $30.20 | Professional | 55 · Aftercare only | $6.76 | $12.30 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $8.13 Typical High $20.42 | Professional | 56 · Pre-op care only | $4.57 | $8.13 | $20.42 |
Where Virginia sits
The same service costs 4.6 times more in Wisconsin than in Washington, DC. 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· 43rd of 51
$91.20
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.