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 $144.54 Median $3,981.07 Typical High $9,332.54 | Facility | None | $144.54 | $3,981.07 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $144.54 Typical High $288.40 | Professional | None | $85.11 | $144.54 | $288.40 |
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 $79.43 Median $123.03 Typical High $181.97 | Professional | None | $79.43 | $123.03 | $181.97 |
CareFirst Setting Professional Modifier None Typical Low $77.62 Median $87.10 Typical High $1,659.59 | Professional | None | $77.62 | $87.10 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $501.19 Typical High $1,621.81 | Facility | None | $316.23 | $501.19 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $131.83 Typical High $239.88 | Professional | None | $81.28 | $131.83 | $239.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $70.79 Median $165.96 Typical High $204.17 | Professional | None | $70.79 | $165.96 | $204.17 |
Medcost Setting Professional Modifier None Typical Low $229.09 Median $288.40 Typical High $288.40 | Professional | None | $229.09 | $288.40 | $288.40 |
Medcost Setting Facility Modifier None Typical Low $91.20 Median $144.54 Typical High $234.42 | Facility | None | $91.20 | $144.54 | $234.42 |
Medcost Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
Sentara Setting Facility Modifier None Typical Low $83.18 Median $616.60 Typical High $2,951.21 | Facility | None | $83.18 | $616.60 | $2,951.21 |
Sentara Setting Professional Modifier None Typical Low $134.90 Median $186.21 Typical High $1,737.80 | Professional | None | $134.90 | $186.21 | $1,737.80 |
United Setting Facility Modifier None Typical Low $323.59 Median $1,445.44 Typical High $3,630.78 | Facility | None | $323.59 | $1,445.44 | $3,630.78 |
United Setting Professional Modifier None Typical Low $74.13 Median $138.04 Typical High $251.19 | Professional | None | $74.13 | $138.04 | $251.19 |
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 $42.66 Median $57.54 Typical High $75.86 | Professional | 52 · Reduced service | $42.66 | $57.54 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $23.44 Typical High $30.20 | Professional | 53 · Discontinued | $16.98 | $23.44 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $87.10 Typical High $114.82 | Professional | 54 · Surgery only | $64.57 | $87.10 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $17.38 Typical High $22.91 | Professional | 55 · Aftercare only | $12.88 | $17.38 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $11.48 Typical High $15.14 | Professional | 56 · Pre-op care only | $8.51 | $11.48 | $15.14 |
Where Virginia sits
The same service costs 3.6 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· 43rd of 51
$145
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.