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 $4,365.16 Typical High $14,125.38 | Facility | None | $64.57 | $4,365.16 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $77.62 Typical High $112.20 | Professional | None | $47.86 | $77.62 | $112.20 |
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 $54.95 Median $87.10 Typical High $120.23 | Professional | None | $54.95 | $87.10 | $120.23 |
CareFirst Setting Professional Modifier None Typical Low $57.54 Median $64.57 Typical High $1,513.56 | Professional | None | $57.54 | $64.57 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $138.04 Typical High $1,621.81 | Facility | None | $51.29 | $138.04 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $87.10 Typical High $138.04 | Professional | None | $54.95 | $87.10 | $138.04 |
Kaiser Permanente Setting Professional Modifier None Typical Low $47.86 Median $107.15 Typical High $134.90 | Professional | None | $47.86 | $107.15 | $134.90 |
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 $64.57 Median $97.72 Typical High $158.49 | Facility | None | $64.57 | $97.72 | $158.49 |
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 $58.88 Median $309.03 Typical High $2,454.71 | Facility | None | $58.88 | $309.03 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $85.11 Median $114.82 Typical High $870.96 | Professional | None | $85.11 | $114.82 | $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 $51.29 Median $89.13 Typical High $158.49 | Professional | None | $51.29 | $89.13 | $158.49 |
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 $23.99 Median $38.02 Typical High $47.86 | Professional | 52 · Reduced service | $23.99 | $38.02 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $15.14 Typical High $19.50 | Professional | 53 · Discontinued | $9.55 | $15.14 | $19.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $57.54 Typical High $72.44 | Professional | 54 · Surgery only | $35.48 | $57.54 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $11.48 Typical High $14.45 | Professional | 55 · Aftercare only | $7.08 | $11.48 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $7.59 Typical High $9.77 | Professional | 56 · Pre-op care only | $4.79 | $7.59 | $9.77 |
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· 42nd of 51
$89.13
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.