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 $72.44 Median $223.87 Typical High $8,317.64 | Facility | None | $72.44 | $223.87 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $104.71 Typical High $213.80 | Professional | None | $54.95 | $104.71 | $213.80 |
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 $51.29 Median $85.11 Typical High $125.89 | Professional | None | $51.29 | $85.11 | $125.89 |
CareFirst Setting Professional Modifier None Typical Low $53.70 Median $58.88 Typical High $691.83 | Professional | None | $53.70 | $58.88 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $186.21 Typical High $1,621.81 | Facility | None | $69.18 | $186.21 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $95.50 Typical High $165.96 | Professional | None | $52.48 | $95.50 | $165.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $81.28 Median $117.49 Typical High $147.91 | Professional | None | $81.28 | $117.49 | $147.91 |
Medcost Setting Professional Modifier None Typical Low $158.49 Median $194.98 Typical High $194.98 | Professional | None | $158.49 | $194.98 | $194.98 |
Medcost Setting Facility Modifier None Typical Low $58.88 Median $97.72 Typical High $169.82 | Facility | None | $58.88 | $97.72 | $169.82 |
Medcost Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
Sentara Setting Facility Modifier None Typical Low $54.95 Median $371.54 Typical High $2,454.71 | Facility | None | $54.95 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $91.20 Median $128.82 Typical High $870.96 | Professional | None | $91.20 | $128.82 | $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 $48.98 Median $93.33 Typical High $173.78 | Professional | None | $48.98 | $93.33 | $173.78 |
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 $27.54 Median $40.74 Typical High $54.95 | Professional | 52 · Reduced service | $27.54 | $40.74 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $16.22 Typical High $21.88 | Professional | 53 · Discontinued | $10.96 | $16.22 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $61.66 Typical High $81.28 | Professional | 54 · Surgery only | $40.74 | $61.66 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $12.30 Typical High $16.22 | Professional | 55 · Aftercare only | $8.32 | $12.30 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $8.13 Typical High $10.96 | Professional | 56 · Pre-op care only | $5.50 | $8.13 | $10.96 |
Where Virginia sits
The same service costs 2.8 times more in Wisconsin than in Kentucky. 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· 40th of 51
$97.72
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.