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 $72.44 Median $3,801.89 Typical High $14,125.38 | Facility | None | $72.44 | $3,801.89 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $162.18 Typical High $204.17 | Professional | None | $63.10 | $162.18 | $204.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $64.57 Median $158.49 Typical High $257.04 | Professional | None | $64.57 | $158.49 | $257.04 |
CareFirst Setting Professional Modifier None Typical Low $63.10 Median $70.79 Typical High $89.13 | Professional | None | $63.10 | $70.79 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $199.53 Typical High $229.09 | Facility | None | $169.82 | $199.53 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $162.18 Typical High $288.40 | Professional | None | $63.10 | $162.18 | $288.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $194.98 Median $229.09 Typical High $288.40 | Professional | None | $194.98 | $229.09 | $288.40 |
Medcost Setting Professional Modifier None Typical Low $162.18 Median $204.17 Typical High $213.80 | Professional | None | $162.18 | $204.17 | $213.80 |
Medcost Setting Facility Modifier None Typical Low $95.50 Median $125.89 Typical High $346.74 | Facility | None | $95.50 | $125.89 | $346.74 |
Medcost Setting Professional Modifier None Typical Low $151.36 Median $162.18 Typical High $208.93 | Professional | None | $151.36 | $162.18 | $208.93 |
Sentara Setting Facility Modifier None Typical Low $48.98 Median $89.13 Typical High $10,232.93 | Facility | None | $48.98 | $89.13 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $162.18 Median $218.78 Typical High $457.09 | Professional | None | $162.18 | $218.78 | $457.09 |
United Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
United Setting Professional Modifier None Typical Low $58.88 Median $138.04 Typical High $295.12 | Professional | None | $58.88 | $138.04 | $295.12 |
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 $30.90 Median $47.86 Typical High $102.33 | Professional | 52 · Reduced service | $30.90 | $47.86 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $19.05 Typical High $40.74 | Professional | 53 · Discontinued | $12.59 | $19.05 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $70.79 Typical High $151.36 | Professional | 54 · Surgery only | $46.77 | $70.79 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $14.13 Typical High $30.20 | Professional | 55 · Aftercare only | $9.33 | $14.13 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $9.55 Typical High $20.42 | Professional | 56 · Pre-op care only | $6.31 | $9.55 | $20.42 |
Where Virginia sits
The same service costs 2.9 times more in Washington 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· 37th of 51
$162
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.