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 $89.13 Median $2,041.74 Typical High $8,317.64 | Facility | None | $89.13 | $2,041.74 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $93.33 Typical High $165.96 | Professional | None | $53.70 | $93.33 | $165.96 |
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 $63.10 Median $100.00 Typical High $138.04 | Professional | None | $63.10 | $100.00 | $138.04 |
CareFirst Setting Professional Modifier None Typical Low $66.07 Median $74.13 Typical High $1,513.56 | Professional | None | $66.07 | $74.13 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $162.18 Typical High $1,621.81 | Facility | None | $60.26 | $162.18 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $97.72 Typical High $154.88 | Professional | None | $63.10 | $97.72 | $154.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $56.23 Median $123.03 Typical High $151.36 | Professional | None | $56.23 | $123.03 | $151.36 |
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 $74.13 Median $102.33 Typical High $169.82 | Facility | None | $74.13 | $102.33 | $169.82 |
Medcost Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
Sentara Setting Facility Modifier None Typical Low $66.07 Median $616.60 Typical High $2,951.21 | Facility | None | $66.07 | $616.60 | $2,951.21 |
Sentara Setting Professional Modifier None Typical Low $87.10 Median $123.03 Typical High $1,737.80 | Professional | None | $87.10 | $123.03 | $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 $57.54 Median $100.00 Typical High $169.82 | Professional | None | $57.54 | $100.00 | $169.82 |
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 $26.92 Median $43.65 Typical High $51.29 | Professional | 52 · Reduced service | $26.92 | $43.65 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $17.38 Typical High $20.42 | Professional | 53 · Discontinued | $10.72 | $17.38 | $20.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $64.57 Typical High $77.62 | Professional | 54 · Surgery only | $39.81 | $64.57 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $12.88 Typical High $15.49 | Professional | 55 · Aftercare only | $8.13 | $12.88 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $8.71 Typical High $10.23 | Professional | 56 · Pre-op care only | $5.37 | $8.71 | $10.23 |
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· 37th of 51
$102
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.