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 $28.84 Median $134.90 Typical High $8,317.64 | Facility | None | $28.84 | $134.90 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $15.14 Median $45.71 Typical High $102.33 | Professional | None | $15.14 | $45.71 | $102.33 |
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 $25.12 Median $40.74 Typical High $58.88 | Professional | None | $25.12 | $40.74 | $58.88 |
CareFirst Setting Professional Modifier None Typical Low $25.12 Median $28.18 Typical High $691.83 | Professional | None | $25.12 | $28.18 | $691.83 |
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 $25.12 Median $42.66 Typical High $91.20 | Professional | None | $25.12 | $42.66 | $91.20 |
Kaiser Permanente Setting Professional Modifier None Typical Low $21.38 Median $53.70 Typical High $66.07 | Professional | None | $21.38 | $53.70 | $66.07 |
Medcost Setting Professional Modifier None Typical Low $97.72 Median $123.03 Typical High $123.03 | Professional | None | $97.72 | $123.03 | $123.03 |
Medcost Setting Facility Modifier None Typical Low $28.84 Median $46.77 Typical High $87.10 | Facility | None | $28.84 | $46.77 | $87.10 |
Medcost Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
Sentara Setting Facility Modifier None Typical Low $26.30 Median $218.78 Typical High $2,454.71 | Facility | None | $26.30 | $218.78 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $50.12 Median $66.07 Typical High $870.96 | Professional | None | $50.12 | $66.07 | $870.96 |
United Setting Facility Modifier None Typical Low $100.00 Median $645.65 Typical High $2,041.74 | Facility | None | $100.00 | $645.65 | $2,041.74 |
United Setting Professional Modifier None Typical Low $23.44 Median $45.71 Typical High $91.20 | Professional | None | $23.44 | $45.71 | $91.20 |
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 $7.59 Median $14.45 Typical High $25.12 | Professional | 52 · Reduced service | $7.59 | $14.45 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.02 Median $5.75 Typical High $10.00 | Professional | 53 · Discontinued | $3.02 | $5.75 | $10.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $11.22 Median $21.38 Typical High $37.15 | Professional | 54 · Surgery only | $11.22 | $21.38 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.24 Median $4.27 Typical High $7.41 | Professional | 55 · Aftercare only | $2.24 | $4.27 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.51 Median $2.88 Typical High $5.01 | Professional | 56 · Pre-op care only | $1.51 | $2.88 | $5.01 |
Where Virginia sits
The same service costs 3.4 times more in Wisconsin 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· 47th of 51
$44.67
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.