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 $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $63.10 Typical High $69.18 | Professional | None | $53.70 | $63.10 | $69.18 |
CareFirst Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,047.13 | $1,047.13 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $1,122.02 Median $1,905.46 Typical High $1,949.84 | Facility | None | $1,122.02 | $1,905.46 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $85.11 Median $100.00 Typical High $125.89 | Professional | None | $85.11 | $100.00 | $125.89 |
Medcost Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
Sentara Setting Facility Modifier None Typical Low $72.44 Median $109.65 Typical High $10,232.93 | Facility | None | $72.44 | $109.65 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $51.29 Median $97.72 Typical High $125.89 | Professional | None | $51.29 | $97.72 | $125.89 |
United Setting Facility Modifier None Typical Low $2,951.21 Median $3,235.94 Typical High $7,244.36 | Facility | None | $2,951.21 | $3,235.94 | $7,244.36 |
United Setting Professional Modifier None Typical Low $74.13 Median $87.10 Typical High $154.88 | Professional | None | $74.13 | $87.10 | $154.88 |
4 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 $45.71 Median $45.71 Typical High $45.71 | Professional | 52 · Reduced service | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | 53 · Discontinued | $18.20 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | 55 · Aftercare only | $13.49 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | 56 · Pre-op care only | $9.12 | $9.12 | $9.12 |
Where Virginia sits
The same service costs 3.2 times more in Alaska than in New York. 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· 49th of 51
$69.18
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.