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 $45.71 Median $4,365.16 Typical High $14,125.38 | Facility | None | $45.71 | $4,365.16 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $72.44 Typical High $95.50 | Professional | None | $43.65 | $72.44 | $95.50 |
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 $38.90 Median $63.10 Typical High $97.72 | Professional | None | $38.90 | $63.10 | $97.72 |
CareFirst Setting Professional Modifier None Typical Low $40.74 Median $45.71 Typical High $691.83 | Professional | None | $40.74 | $45.71 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $1,230.27 | Facility | None | $50.12 | $50.12 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $72.44 Typical High $112.20 | Professional | None | $40.74 | $72.44 | $112.20 |
Kaiser Permanente Setting Professional Modifier None Typical Low $35.48 Median $91.20 Typical High $112.20 | Professional | None | $35.48 | $91.20 | $112.20 |
Medcost Setting Professional Modifier None Typical Low $97.72 Median $123.03 Typical High $123.03 | Professional | None | $97.72 | $123.03 | $123.03 |
Medcost Setting Facility Modifier None Typical Low $45.71 Median $74.13 Typical High $125.89 | Facility | None | $45.71 | $74.13 | $125.89 |
Medcost Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
Sentara Setting Facility Modifier None Typical Low $38.90 Median $218.78 Typical High $2,454.71 | Facility | None | $38.90 | $218.78 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $69.18 Median $97.72 Typical High $870.96 | Professional | None | $69.18 | $97.72 | $870.96 |
United Setting Facility Modifier None Typical Low $100.00 Median $645.65 Typical High $2,041.74 | Facility | None | $100.00 | $645.65 | $2,041.74 |
United Setting Professional Modifier None Typical Low $36.31 Median $67.61 Typical High $125.89 | Professional | None | $36.31 | $67.61 | $125.89 |
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 $21.88 Median $30.20 Typical High $41.69 | Professional | 52 · Reduced service | $21.88 | $30.20 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $12.30 Typical High $16.60 | Professional | 53 · Discontinued | $8.71 | $12.30 | $16.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $45.71 Typical High $61.66 | Professional | 54 · Surgery only | $32.36 | $45.71 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $9.12 Typical High $12.59 | Professional | 55 · Aftercare only | $6.46 | $9.12 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $6.03 Typical High $8.32 | Professional | 56 · Pre-op care only | $4.37 | $6.03 | $8.32 |
Where Virginia sits
The same service costs 3.4 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
$74.13
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.