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 $18.20 Median $21.88 Typical High $38.02 | Facility | None | $18.20 | $21.88 | $38.02 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $33.11 Typical High $38.02 | Professional | None | $18.20 | $33.11 | $38.02 |
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 $16.98 Median $20.42 Typical High $24.55 | Professional | None | $16.98 | $20.42 | $24.55 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $21.88 Median $29.51 Typical High $36.31 | Professional | 50 · Both sides | $21.88 | $29.51 | $36.31 |
CareFirst Setting Professional Modifier None Typical Low $17.38 Median $19.50 Typical High $25.70 | Professional | None | $17.38 | $19.50 | $25.70 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $1,230.27 | Facility | None | $50.12 | $50.12 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $33.88 Typical High $61.66 | Professional | None | $18.20 | $33.88 | $61.66 |
Kaiser Permanente Setting Professional Modifier None Typical Low $33.88 Median $40.74 Typical High $51.29 | Professional | None | $33.88 | $40.74 | $51.29 |
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 $21.88 Median $48.98 Typical High $63.10 | Facility | None | $21.88 | $48.98 | $63.10 |
Medcost Setting Professional Modifier None Typical Low $30.20 Median $39.81 Typical High $58.88 | Professional | None | $30.20 | $39.81 | $58.88 |
Sentara Setting Facility Modifier None Typical Low $20.89 Median $131.83 Typical High $2,454.71 | Facility | None | $20.89 | $131.83 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $36.31 Median $53.70 Typical High $89.13 | Professional | None | $36.31 | $53.70 | $89.13 |
United Setting Facility Modifier None Typical Low $100.00 Median $645.65 Typical High $2,041.74 | Facility | None | $100.00 | $645.65 | $2,041.74 |
United Setting Professional Modifier None Typical Low $14.79 Median $30.90 Typical High $66.07 | Professional | None | $14.79 | $30.90 | $66.07 |
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 $9.12 Median $15.49 Typical High $19.05 | Professional | 52 · Reduced service | $9.12 | $15.49 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $6.17 Typical High $7.59 | Professional | 53 · Discontinued | $3.63 | $6.17 | $7.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.69 Median $4.68 Typical High $5.75 | Professional | 55 · Aftercare only | $2.69 | $4.68 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $3.09 Typical High $3.80 | Professional | 56 · Pre-op care only | $1.82 | $3.09 | $3.80 |
Where Virginia sits
The same service costs 3.8 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.