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 $109.65 Median $120.23 Typical High $158.49 | Facility | None | $109.65 | $120.23 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $141.25 Typical High $158.49 | Professional | None | $109.65 | $141.25 | $158.49 |
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 $100.00 Median $120.23 Typical High $144.54 | Professional | None | $100.00 | $120.23 | $144.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $151.36 Median $177.83 Typical High $213.80 | Professional | 50 · Both sides | $151.36 | $177.83 | $213.80 |
CareFirst Setting Professional Modifier None Typical Low $85.11 Median $93.33 Typical High $112.20 | Professional | None | $85.11 | $93.33 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $100.00 Typical High $186.21 | Facility | None | $50.12 | $100.00 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $141.25 Typical High $213.80 | Professional | None | $102.33 | $141.25 | $213.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $151.36 Median $181.97 Typical High $229.09 | Professional | None | $151.36 | $181.97 | $229.09 |
Medcost Setting Professional Modifier None Typical Low $173.78 Median $218.78 Typical High $218.78 | Professional | None | $173.78 | $218.78 | $218.78 |
Medcost Setting Facility Modifier None Typical Low $120.23 Median $158.49 Typical High $257.04 | Facility | None | $120.23 | $158.49 | $257.04 |
Medcost Setting Professional Modifier None Typical Low $125.89 Median $138.04 Typical High $162.18 | Professional | None | $125.89 | $138.04 | $162.18 |
Sentara Setting Facility Modifier None Typical Low $93.33 Median $371.54 Typical High $2,454.71 | Facility | None | $93.33 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $100.00 Median $169.82 Typical High $338.84 | Professional | None | $100.00 | $169.82 | $338.84 |
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 $81.28 Median $123.03 Typical High $234.42 | Professional | None | $81.28 | $123.03 | $234.42 |
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 $54.95 Median $69.18 Typical High $79.43 | Professional | 52 · Reduced service | $54.95 | $69.18 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $27.54 Typical High $31.62 | Professional | 53 · Discontinued | $21.88 | $27.54 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $20.42 Typical High $23.44 | Professional | 55 · Aftercare only | $16.60 | $20.42 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $13.80 Typical High $15.85 | Professional | 56 · Pre-op care only | $10.96 | $13.80 | $15.85 |
Where Virginia sits
The same service costs 4.0 times more in Alaska than in Florida. 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· 47th of 51
$126
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.