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 $338.84 Median $4,365.16 Typical High $10,000.00 | Facility | None | $338.84 | $4,365.16 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $338.84 Typical High $512.86 | Professional | None | $204.17 | $338.84 | $512.86 |
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 $190.55 Median $316.23 Typical High $457.09 | Professional | None | $190.55 | $316.23 | $457.09 |
CareFirst Setting Professional Modifier None Typical Low $190.55 Median $208.93 Typical High $2,511.89 | Professional | None | $190.55 | $208.93 | $2,511.89 |
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 $194.98 Median $323.59 Typical High $524.81 | Professional | None | $194.98 | $323.59 | $524.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $165.96 Median $380.19 Typical High $467.74 | Professional | None | $165.96 | $380.19 | $467.74 |
Medcost Setting Professional Modifier None Typical Low $380.19 Median $478.63 Typical High $478.63 | Professional | None | $380.19 | $478.63 | $478.63 |
Medcost Setting Facility Modifier None Typical Low $223.87 Median $338.84 Typical High $549.54 | Facility | None | $223.87 | $338.84 | $549.54 |
Medcost Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
Sentara Setting Facility Modifier None Typical Low $190.55 Median $933.25 Typical High $3,715.35 | Facility | None | $190.55 | $933.25 | $3,715.35 |
Sentara Setting Professional Modifier None Typical Low $302.00 Median $407.38 Typical High $2,137.96 | Professional | None | $302.00 | $407.38 | $2,137.96 |
United Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $5,888.44 | Facility | None | $588.84 | $2,187.76 | $5,888.44 |
United Setting Professional Modifier None Typical Low $173.78 Median $309.03 Typical High $562.34 | Professional | None | $173.78 | $309.03 | $562.34 |
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 $102.33 Median $128.82 Typical High $194.98 | Professional | 52 · Reduced service | $102.33 | $128.82 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $51.29 Typical High $77.62 | Professional | 53 · Discontinued | $40.74 | $51.29 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $190.55 Typical High $295.12 | Professional | 54 · Surgery only | $154.88 | $190.55 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $38.90 Typical High $58.88 | Professional | 55 · Aftercare only | $30.90 | $38.90 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $25.70 Typical High $38.90 | Professional | 56 · Pre-op care only | $20.42 | $25.70 | $38.90 |
Where Virginia sits
The same service costs 3.0 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
$339
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.