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 $131.83 Median $3,801.89 Typical High $9,332.54 | Facility | None | $131.83 | $3,801.89 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $151.36 Typical High $239.88 | Professional | None | $85.11 | $151.36 | $239.88 |
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 $97.72 Median $141.25 Typical High $204.17 | Professional | None | $97.72 | $141.25 | $204.17 |
CareFirst Setting Professional Modifier None Typical Low $102.33 Median $112.20 Typical High $691.83 | Professional | None | $102.33 | $112.20 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $218.78 Typical High $1,621.81 | Facility | None | $81.28 | $218.78 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $147.91 Typical High $229.09 | Professional | None | $97.72 | $147.91 | $229.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $85.11 Median $173.78 Typical High $213.80 | Professional | None | $85.11 | $173.78 | $213.80 |
Medcost Setting Professional Modifier None Typical Low $186.21 Median $234.42 Typical High $234.42 | Professional | None | $186.21 | $234.42 | $234.42 |
Medcost Setting Facility Modifier None Typical Low $114.82 Median $154.88 Typical High $251.19 | Facility | None | $114.82 | $154.88 | $251.19 |
Medcost Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
Sentara Setting Facility Modifier None Typical Low $104.71 Median $371.54 Typical High $2,454.71 | Facility | None | $104.71 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $134.90 Median $181.97 Typical High $870.96 | Professional | None | $134.90 | $181.97 | $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 $89.13 Median $151.36 Typical High $257.04 | Professional | None | $89.13 | $151.36 | $257.04 |
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 $41.69 Median $64.57 Typical High $77.62 | Professional | 52 · Reduced service | $41.69 | $64.57 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $26.30 Typical High $30.90 | Professional | 53 · Discontinued | $16.60 | $26.30 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $97.72 Typical High $114.82 | Professional | 54 · Surgery only | $63.10 | $97.72 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $19.50 Typical High $23.44 | Professional | 55 · Aftercare only | $12.59 | $19.50 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $12.88 Typical High $15.49 | Professional | 56 · Pre-op care only | $8.32 | $12.88 | $15.49 |
Where Virginia sits
The same service costs 3.2 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· 36th of 51
$151
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.