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 $4,073.80 Typical High $10,000.00 | Facility | None | $72.44 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $93.33 Typical High $162.18 | Professional | None | $67.61 | $93.33 | $162.18 |
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 $61.66 Median $85.11 Typical High $117.49 | Professional | None | $61.66 | $85.11 | $117.49 |
CareFirst Setting Professional Modifier None Typical Low $64.57 Median $72.44 Typical High $707.95 | Professional | None | $64.57 | $72.44 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $47.86 Median $128.82 Typical High $1,621.81 | Facility | None | $47.86 | $128.82 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $89.13 Typical High $138.04 | Professional | None | $64.57 | $89.13 | $138.04 |
Kaiser Permanente Setting Professional Modifier None Typical Low $54.95 Median $107.15 Typical High $131.83 | Professional | None | $54.95 | $107.15 | $131.83 |
Medcost Setting Professional Modifier None Typical Low $120.23 Median $151.36 Typical High $151.36 | Professional | None | $120.23 | $151.36 | $151.36 |
Medcost Setting Facility Modifier None Typical Low $72.44 Median $97.72 Typical High $151.36 | Facility | None | $72.44 | $97.72 | $151.36 |
Medcost Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
Sentara Setting Facility Modifier None Typical Low $63.10 Median $371.54 Typical High $2,454.71 | Facility | None | $63.10 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $83.18 Median $114.82 Typical High $870.96 | Professional | None | $83.18 | $114.82 | $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 $56.23 Median $95.50 Typical High $151.36 | Professional | None | $56.23 | $95.50 | $151.36 |
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 $33.88 Median $40.74 Typical High $48.98 | Professional | 52 · Reduced service | $33.88 | $40.74 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $16.22 Typical High $19.50 | Professional | 53 · Discontinued | $13.49 | $16.22 | $19.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $61.66 Typical High $72.44 | Professional | 54 · Surgery only | $51.29 | $61.66 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $12.30 Typical High $14.79 | Professional | 55 · Aftercare only | $10.23 | $12.30 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $8.13 Typical High $9.77 | Professional | 56 · Pre-op care only | $6.76 | $8.13 | $9.77 |
Where Virginia sits
The same service costs 3.5 times more in Wisconsin than in Florida. 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· 38th of 51
$93.33
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.