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 $245.47 Median $4,365.16 Typical High $10,000.00 | Facility | None | $245.47 | $4,365.16 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $812.83 Typical High $1,047.13 | Professional | None | $234.42 | $812.83 | $1,047.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $6,606.93 Typical High $7,244.36 | Facility | None | $5,011.87 | $6,606.93 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $660.69 Typical High $1,071.52 | Professional | None | $204.17 | $660.69 | $1,071.52 |
CareFirst Setting Professional Modifier None Typical Low $199.53 Median $218.78 Typical High $288.40 | Professional | None | $199.53 | $218.78 | $288.40 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $549.54 Typical High $1,288.25 | Professional | None | $208.93 | $549.54 | $1,288.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $794.33 Median $933.25 Typical High $1,174.90 | Professional | None | $794.33 | $933.25 | $1,174.90 |
Medcost Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | None | $2,089.30 | $2,089.30 | $2,089.30 |
Medcost Setting Facility Modifier None Typical Low $295.12 Median $398.11 Typical High $1,479.11 | Facility | None | $295.12 | $398.11 | $1,479.11 |
Medcost Setting Professional Modifier None Typical Low $724.44 Median $794.33 Typical High $1,096.48 | Professional | None | $724.44 | $794.33 | $1,096.48 |
Sentara Setting Facility Modifier None Typical Low $186.21 Median $407.38 Typical High $10,964.78 | Facility | None | $186.21 | $407.38 | $10,964.78 |
Sentara Setting Professional Modifier None Typical Low $851.14 Median $1,071.52 Typical High $2,290.87 | Professional | None | $851.14 | $1,071.52 | $2,290.87 |
United Setting Facility Modifier None Typical Low $5,754.40 Median $9,772.37 Typical High $19,952.62 | Facility | None | $5,754.40 | $9,772.37 | $19,952.62 |
United Setting Professional Modifier None Typical Low $190.55 Median $645.65 Typical High $1,479.11 | Professional | None | $190.55 | $645.65 | $1,479.11 |
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 $117.49 Median $213.80 Typical High $524.81 | Professional | 52 · Reduced service | $117.49 | $213.80 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $85.11 Typical High $208.93 | Professional | 53 · Discontinued | $46.77 | $85.11 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $316.23 Typical High $776.25 | Professional | 54 · Surgery only | $177.83 | $316.23 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $63.10 Typical High $154.88 | Professional | 55 · Aftercare only | $35.48 | $63.10 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $42.66 Typical High $104.71 | Professional | 56 · Pre-op care only | $23.44 | $42.66 | $104.71 |
Where Virginia sits
The same service costs 5.4 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· 34th of 51
$741
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.