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 $87.10 Median $194.98 Typical High $8,317.64 | Facility | None | $87.10 | $194.98 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $102.33 Typical High $194.98 | Professional | None | $56.23 | $102.33 | $194.98 |
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 $60.26 Median $95.50 Typical High $134.90 | Professional | None | $60.26 | $95.50 | $134.90 |
CareFirst Setting Professional Modifier None Typical Low $63.10 Median $70.79 Typical High $691.83 | Professional | None | $63.10 | $70.79 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $58.88 Typical High $102.33 | Facility | None | $50.12 | $58.88 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $100.00 Typical High $162.18 | Professional | None | $60.26 | $100.00 | $162.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $52.48 Median $114.82 Typical High $141.25 | Professional | None | $52.48 | $114.82 | $141.25 |
Medcost Setting Professional Modifier None Typical Low $151.36 Median $190.55 Typical High $190.55 | Professional | None | $151.36 | $190.55 | $190.55 |
Medcost Setting Facility Modifier None Typical Low $79.43 Median $120.23 Typical High $169.82 | Facility | None | $79.43 | $120.23 | $169.82 |
Medcost Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
Sentara Setting Facility Modifier None Typical Low $72.44 Median $323.59 Typical High $2,454.71 | Facility | None | $72.44 | $323.59 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $97.72 Median $134.90 Typical High $870.96 | Professional | None | $97.72 | $134.90 | $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 $60.26 Median $114.82 Typical High $177.83 | Professional | None | $60.26 | $114.82 | $177.83 |
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 $25.70 Median $43.65 Typical High $51.29 | Professional | 52 · Reduced service | $25.70 | $43.65 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $17.38 Typical High $20.89 | Professional | 53 · Discontinued | $10.47 | $17.38 | $20.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $64.57 Typical High $77.62 | Professional | 54 · Surgery only | $38.90 | $64.57 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $13.18 Typical High $15.49 | Professional | 55 · Aftercare only | $7.76 | $13.18 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $8.71 Typical High $10.23 | Professional | 56 · Pre-op care only | $5.13 | $8.71 | $10.23 |
Where Virginia sits
The same service costs 3.0 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· 42nd 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.