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 $64.57 Median $117.49 Typical High $9,332.54 | Facility | None | $64.57 | $117.49 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $69.18 Typical High $117.49 | Professional | None | $38.90 | $69.18 | $117.49 |
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 $44.67 Median $69.18 Typical High $97.72 | Professional | None | $44.67 | $69.18 | $97.72 |
CareFirst Setting Professional Modifier None Typical Low $46.77 Median $51.29 Typical High $691.83 | Professional | None | $46.77 | $51.29 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $50.12 Typical High $75.86 | Facility | None | $36.31 | $50.12 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $70.79 Typical High $112.20 | Professional | None | $44.67 | $70.79 | $112.20 |
Kaiser Permanente Setting Professional Modifier None Typical Low $38.90 Median $81.28 Typical High $102.33 | Professional | None | $38.90 | $81.28 | $102.33 |
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 $52.48 Median $70.79 Typical High $114.82 | Facility | None | $52.48 | $70.79 | $114.82 |
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 $47.86 Median $302.00 Typical High $2,454.71 | Facility | None | $47.86 | $302.00 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $72.44 Median $95.50 Typical High $870.96 | Professional | None | $72.44 | $95.50 | $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 $40.74 Median $72.44 Typical High $123.03 | Professional | None | $40.74 | $72.44 | $123.03 |
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 $19.05 Median $30.90 Typical High $35.48 | Professional | 52 · Reduced service | $19.05 | $30.90 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $12.30 Typical High $14.13 | Professional | 53 · Discontinued | $7.59 | $12.30 | $14.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.18 Median $46.77 Typical High $52.48 | Professional | 54 · Surgery only | $28.18 | $46.77 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $9.33 Typical High $10.47 | Professional | 55 · Aftercare only | $5.62 | $9.33 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $6.17 Typical High $7.08 | Professional | 56 · Pre-op care only | $3.80 | $6.17 | $7.08 |
Where Virginia sits
The same service costs 3.1 times more in Wisconsin than in Washington, DC. 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· 41st of 51
$72.44
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.