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 $218.78 Median $5,495.41 Typical High $14,125.38 | Facility | None | $218.78 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $218.78 Typical High $218.78 | Professional | None | $181.97 | $218.78 | $218.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $363.08 | Professional | None | $281.84 | $281.84 | $363.08 |
CareFirst Setting Professional Modifier None Typical Low $263.03 Median $295.12 Typical High $380.19 | Professional | None | $263.03 | $295.12 | $380.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $213.80 Median $257.04 Typical High $316.23 | Professional | None | $213.80 | $257.04 | $316.23 |
Medcost Setting Facility Modifier None Typical Low $218.78 Median $263.03 Typical High $331.13 | Facility | None | $218.78 | $263.03 | $331.13 |
Medcost Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
Sentara Setting Facility Modifier None Typical Low $177.83 Median $380.19 Typical High $10,232.93 | Facility | None | $177.83 | $380.19 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $181.97 Median $257.04 Typical High $4,570.88 | Professional | None | $181.97 | $257.04 | $4,570.88 |
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 $91.20 Median $107.15 Typical High $109.65 | Professional | 52 · Reduced service | $91.20 | $107.15 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $43.65 Typical High $43.65 | Professional | 53 · Discontinued | $37.15 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $162.18 Typical High $162.18 | Professional | 54 · Surgery only | $138.04 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $32.36 Typical High $32.36 | Professional | 55 · Aftercare only | $27.54 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $21.38 Typical High $21.88 | Professional | 56 · Pre-op care only | $18.20 | $21.38 | $21.88 |
Where Virginia sits
The same service costs 25.7 times more in Oklahoma than in Vermont. 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· 26th of 51
$282
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.