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 $186.21 Median $5,495.41 Typical High $14,125.38 | Facility | None | $186.21 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $186.21 Typical High $186.21 | Professional | None | $154.88 | $186.21 | $186.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $316.23 | Professional | None | $245.47 | $245.47 | $316.23 |
CareFirst Setting Professional Modifier None Typical Low $204.17 Median $229.09 Typical High $302.00 | Professional | None | $204.17 | $229.09 | $302.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $177.83 Median $213.80 Typical High $263.03 | Professional | None | $177.83 | $213.80 | $263.03 |
Medcost Setting Facility Modifier None Typical Low $186.21 Median $223.87 Typical High $281.84 | Facility | None | $186.21 | $223.87 | $281.84 |
Medcost Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
Sentara Setting Facility Modifier None Typical Low $151.36 Median $323.59 Typical High $10,232.93 | Facility | None | $151.36 | $323.59 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $173.78 Median $288.40 Typical High $7,413.10 | Professional | None | $173.78 | $288.40 | $7,413.10 |
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 $77.62 Median $89.13 Typical High $93.33 | Professional | 52 · Reduced service | $77.62 | $89.13 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $36.31 Typical High $37.15 | Professional | 53 · Discontinued | $30.90 | $36.31 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $134.90 Typical High $138.04 | Professional | 54 · Surgery only | $114.82 | $134.90 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $26.92 Typical High $28.18 | Professional | 55 · Aftercare only | $22.91 | $26.92 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $18.20 Typical High $18.62 | Professional | 56 · Pre-op care only | $15.49 | $18.20 | $18.62 |
Where Virginia sits
The same service costs 7.6 times more in Nebraska than in West Virginia. 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· 24th of 51
$245
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.