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 $70.79 Median $2,570.40 Typical High $9,332.54 | Facility | None | $70.79 | $2,570.40 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $141.25 Typical High $257.04 | Professional | None | $41.69 | $141.25 | $257.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $35.48 Median $125.89 Typical High $229.09 | Professional | None | $35.48 | $125.89 | $229.09 |
CareFirst Setting Professional Modifier None Typical Low $34.67 Median $38.90 Typical High $53.70 | Professional | None | $34.67 | $38.90 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $91.20 Typical High $269.15 | Professional | None | $37.15 | $91.20 | $269.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $169.82 Median $199.53 Typical High $251.19 | Professional | None | $169.82 | $199.53 | $251.19 |
Medcost Setting Professional Modifier None Typical Low $64.57 Median $251.19 Typical High $251.19 | Professional | None | $64.57 | $251.19 | $251.19 |
Medcost Setting Facility Modifier None Typical Low $58.88 Median $70.79 Typical High $275.42 | Facility | None | $58.88 | $70.79 | $275.42 |
Medcost Setting Professional Modifier None Typical Low $50.12 Median $63.10 Typical High $186.21 | Professional | None | $50.12 | $63.10 | $186.21 |
Sentara Setting Facility Modifier None Typical Low $33.88 Median $58.88 Typical High $10,232.93 | Facility | None | $33.88 | $58.88 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $50.12 Median $204.17 Typical High $446.68 | Professional | None | $50.12 | $204.17 | $446.68 |
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 $33.88 Median $107.15 Typical High $295.12 | Professional | None | $33.88 | $107.15 | $295.12 |
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 $20.89 Median $37.15 Typical High $114.82 | Professional | 52 · Reduced service | $20.89 | $37.15 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $15.14 Typical High $45.71 | Professional | 53 · Discontinued | $8.32 | $15.14 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $56.23 Typical High $169.82 | Professional | 54 · Surgery only | $31.62 | $56.23 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $11.22 Typical High $33.88 | Professional | 55 · Aftercare only | $6.31 | $11.22 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $7.59 Typical High $22.91 | Professional | 56 · Pre-op care only | $4.17 | $7.59 | $22.91 |
Where Virginia sits
The same service costs 4.5 times more in Wisconsin than in Michigan. 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· 32nd 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.