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 $42.66 Median $169.82 Typical High $8,317.64 | Facility | None | $42.66 | $169.82 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $83.18 Typical High $154.88 | Professional | None | $31.62 | $83.18 | $154.88 |
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 $29.51 Median $53.70 Typical High $100.00 | Professional | None | $29.51 | $53.70 | $100.00 |
CareFirst Setting Professional Modifier None Typical Low $30.20 Median $33.11 Typical High $691.83 | Professional | None | $30.20 | $33.11 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $64.57 Typical High $109.65 | Facility | None | $50.12 | $64.57 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $30.20 Median $74.13 Typical High $123.03 | Professional | None | $30.20 | $74.13 | $123.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $63.10 Median $93.33 Typical High $123.03 | Professional | None | $63.10 | $93.33 | $123.03 |
Medcost Setting Professional Modifier None Typical Low $120.23 Median $151.36 Typical High $151.36 | Professional | None | $120.23 | $151.36 | $151.36 |
Medcost Setting Facility Modifier None Typical Low $33.88 Median $66.07 Typical High $134.90 | Facility | None | $33.88 | $66.07 | $134.90 |
Medcost Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
Sentara Setting Facility Modifier None Typical Low $31.62 Median $371.54 Typical High $2,454.71 | Facility | None | $31.62 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $74.13 Median $107.15 Typical High $870.96 | Professional | None | $74.13 | $107.15 | $870.96 |
United Setting Facility Modifier None Typical Low $100.00 Median $660.69 Typical High $2,041.74 | Facility | None | $100.00 | $660.69 | $2,041.74 |
United Setting Professional Modifier None Typical Low $28.84 Median $67.61 Typical High $134.90 | Professional | None | $28.84 | $67.61 | $134.90 |
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 $15.85 Median $32.36 Typical High $42.66 | Professional | 52 · Reduced service | $15.85 | $32.36 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $12.88 Typical High $17.38 | Professional | 53 · Discontinued | $6.31 | $12.88 | $17.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $23.99 Median $48.98 Typical High $64.57 | Professional | 54 · Surgery only | $23.99 | $48.98 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $9.77 Typical High $12.88 | Professional | 55 · Aftercare only | $4.79 | $9.77 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $6.46 Typical High $8.71 | Professional | 56 · Pre-op care only | $3.16 | $6.46 | $8.71 |
Where Virginia sits
The same service costs 3.1 times more in Wisconsin than in Nebraska. 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
$75.86
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.