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 $426.58 Median $4,365.16 Typical High $10,000.00 | Facility | None | $426.58 | $4,365.16 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $426.58 Typical High $489.78 | Professional | None | $173.78 | $426.58 | $489.78 |
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 $162.18 Median $309.03 Typical High $489.78 | Professional | None | $162.18 | $309.03 | $489.78 |
CareFirst Setting Professional Modifier None Typical Low $158.49 Median $177.83 Typical High $6,918.31 | Professional | None | $158.49 | $177.83 | $6,918.31 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $549.54 Typical High $2,187.76 | Facility | None | $316.23 | $549.54 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $331.13 Typical High $630.96 | Professional | None | $165.96 | $331.13 | $630.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $144.54 Median $426.58 Typical High $524.81 | Professional | None | $144.54 | $426.58 | $524.81 |
Medcost Setting Professional Modifier None Typical Low $645.65 Median $794.33 Typical High $794.33 | Professional | None | $645.65 | $794.33 | $794.33 |
Medcost Setting Facility Modifier None Typical Low $186.21 Median $309.03 Typical High $707.95 | Facility | None | $186.21 | $309.03 | $707.95 |
Medcost Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
Sentara Setting Facility Modifier None Typical Low $158.49 Median $616.60 Typical High $2,951.21 | Facility | None | $158.49 | $616.60 | $2,951.21 |
Sentara Setting Professional Modifier None Typical Low $371.54 Median $512.86 Typical High $1,819.70 | Professional | None | $371.54 | $512.86 | $1,819.70 |
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 $147.91 Median $323.59 Typical High $724.44 | Professional | None | $147.91 | $323.59 | $724.44 |
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 $87.10 Median $165.96 Typical High $218.78 | Professional | 52 · Reduced service | $87.10 | $165.96 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $66.07 Typical High $87.10 | Professional | 53 · Discontinued | $34.67 | $66.07 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $245.47 Typical High $323.59 | Professional | 54 · Surgery only | $128.82 | $245.47 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $48.98 Typical High $64.57 | Professional | 55 · Aftercare only | $26.30 | $48.98 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $33.11 Typical High $43.65 | Professional | 56 · Pre-op care only | $17.38 | $33.11 | $43.65 |
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· 43rd of 51
$363
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.