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 $18.62 Median $21.38 Typical High $35.48 | Facility | None | $18.62 | $21.38 | $35.48 |
Aetna Setting Professional Modifier None Typical Low $18.62 Median $30.90 Typical High $35.48 | Professional | None | $18.62 | $30.90 | $35.48 |
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 $16.60 Median $20.42 Typical High $24.55 | Professional | None | $16.60 | $20.42 | $24.55 |
CareFirst Setting Professional Modifier None Typical Low $16.98 Median $18.62 Typical High $24.55 | Professional | None | $16.98 | $18.62 | $24.55 |
Cigna Setting Facility Modifier None Typical Low $18.20 Median $34.67 Typical High $66.07 | Facility | None | $18.20 | $34.67 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $17.38 Median $31.62 Typical High $61.66 | Professional | None | $17.38 | $31.62 | $61.66 |
Kaiser Permanente Setting Professional Modifier None Typical Low $30.90 Median $37.15 Typical High $45.71 | Professional | None | $30.90 | $37.15 | $45.71 |
Medcost Setting Professional Modifier None Typical Low $67.61 Median $85.11 Typical High $85.11 | Professional | None | $67.61 | $85.11 | $85.11 |
Medcost Setting Facility Modifier None Typical Low $21.38 Median $53.70 Typical High $67.61 | Facility | None | $21.38 | $53.70 | $67.61 |
Medcost Setting Professional Modifier None Typical Low $39.81 Median $44.67 Typical High $64.57 | Professional | None | $39.81 | $44.67 | $64.57 |
Sentara Setting Facility Modifier None Typical Low $20.89 Median $218.78 Typical High $2,454.71 | Facility | None | $20.89 | $218.78 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $33.88 Median $56.23 Typical High $87.10 | Professional | None | $33.88 | $56.23 | $87.10 |
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 $14.45 Median $30.90 Typical High $64.57 | Professional | None | $14.45 | $30.90 | $64.57 |
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 $9.33 Median $14.79 Typical High $17.78 | Professional | 52 · Reduced service | $9.33 | $14.79 | $17.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $6.03 Typical High $7.08 | Professional | 53 · Discontinued | $3.72 | $6.03 | $7.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $4.47 Typical High $5.37 | Professional | 55 · Aftercare only | $2.75 | $4.47 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $2.95 Typical High $3.55 | Professional | 56 · Pre-op care only | $1.86 | $2.95 | $3.55 |
Where Virginia sits
The same service costs 3.5 times more in Alaska than in 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· 51st of 51
$23.99
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.