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 $57.54 Median $4,365.16 Typical High $14,125.38 | Facility | None | $57.54 | $4,365.16 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $87.10 Typical High $186.21 | Professional | None | $54.95 | $87.10 | $186.21 |
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 $51.29 Median $74.13 Typical High $104.71 | Professional | None | $51.29 | $74.13 | $104.71 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $75.86 Median $109.65 Typical High $154.88 | Professional | 50 · Both sides | $75.86 | $109.65 | $154.88 |
CareFirst Setting Professional Modifier None Typical Low $51.29 Median $56.23 Typical High $691.83 | Professional | None | $51.29 | $56.23 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $1,230.27 | Facility | None | $50.12 | $50.12 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $79.43 Typical High $162.18 | Professional | None | $52.48 | $79.43 | $162.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $42.66 Median $91.20 Typical High $112.20 | Professional | None | $42.66 | $91.20 | $112.20 |
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 $57.54 Median $89.13 Typical High $173.78 | Facility | None | $57.54 | $89.13 | $173.78 |
Medcost Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
Sentara Setting Facility Modifier None Typical Low $53.70 Median $281.84 Typical High $2,454.71 | Facility | None | $53.70 | $281.84 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $79.43 Median $144.54 Typical High $870.96 | Professional | None | $79.43 | $144.54 | $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 $47.86 Median $87.10 Typical High $173.78 | Professional | None | $47.86 | $87.10 | $173.78 |
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 $27.54 Median $34.67 Typical High $44.67 | Professional | 52 · Reduced service | $27.54 | $34.67 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $13.80 Typical High $17.78 | Professional | 53 · Discontinued | $10.96 | $13.80 | $17.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $51.29 Typical High $67.61 | Professional | 54 · Surgery only | $41.69 | $51.29 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $10.47 Typical High $13.49 | Professional | 55 · Aftercare only | $8.32 | $10.47 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $6.92 Typical High $8.91 | Professional | 56 · Pre-op care only | $5.50 | $6.92 | $8.91 |
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· 45th of 51
$81.28
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.