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 $39.81 Median $53.70 Typical High $72.44 | Facility | None | $39.81 | $53.70 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $67.61 Typical High $72.44 | Professional | None | $39.81 | $67.61 | $72.44 |
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 $46.77 Median $72.44 Typical High $102.33 | Professional | None | $46.77 | $72.44 | $102.33 |
CareFirst Setting Professional Modifier None Typical Low $47.86 Median $53.70 Typical High $691.83 | Professional | None | $47.86 | $53.70 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $38.02 Median $50.12 Typical High $75.86 | Facility | None | $38.02 | $50.12 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $72.44 Typical High $117.49 | Professional | None | $45.71 | $72.44 | $117.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $39.81 Median $85.11 Typical High $104.71 | Professional | None | $39.81 | $85.11 | $104.71 |
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 $53.70 Median $72.44 Typical High $117.49 | Facility | None | $53.70 | $72.44 | $117.49 |
Medcost Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
Sentara Setting Facility Modifier None Typical Low $48.98 Median $302.00 Typical High $2,454.71 | Facility | None | $48.98 | $302.00 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $67.61 Median $91.20 Typical High $870.96 | Professional | None | $67.61 | $91.20 | $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 $41.69 Median $74.13 Typical High $128.82 | Professional | None | $41.69 | $74.13 | $128.82 |
4 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 $19.95 Median $31.62 Typical High $36.31 | Professional | 52 · Reduced service | $19.95 | $31.62 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $12.59 Typical High $14.45 | Professional | 53 · Discontinued | $7.94 | $12.59 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $9.55 Typical High $10.96 | Professional | 55 · Aftercare only | $5.89 | $9.55 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $6.31 Typical High $7.24 | Professional | 56 · Pre-op care only | $3.98 | $6.31 | $7.24 |
Where Virginia sits
The same service costs 3.1 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· 42nd 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.