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 $15.85 Median $18.62 Typical High $89.13 | Facility | None | $15.85 | $18.62 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $15.85 Median $58.88 Typical High $89.13 | Professional | None | $15.85 | $58.88 | $89.13 |
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 $14.13 Median $17.38 Typical High $20.89 | Professional | None | $14.13 | $17.38 | $20.89 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $18.20 Median $25.12 Typical High $30.20 | Professional | 50 · Both sides | $18.20 | $25.12 | $30.20 |
CareFirst Setting Professional Modifier None Typical Low $11.75 Median $13.18 Typical High $15.49 | Professional | None | $11.75 | $13.18 | $15.49 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $75.86 Typical High $794.33 | Facility | None | $50.12 | $75.86 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $14.79 Median $66.07 Typical High $104.71 | Professional | None | $14.79 | $66.07 | $104.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $74.13 Median $89.13 Typical High $112.20 | Professional | None | $74.13 | $89.13 | $112.20 |
Medcost Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
Medcost Setting Facility Modifier None Typical Low $18.62 Median $30.20 Typical High $147.91 | Facility | None | $18.62 | $30.20 | $147.91 |
Medcost Setting Professional Modifier None Typical Low $53.70 Median $67.61 Typical High $91.20 | Professional | None | $53.70 | $67.61 | $91.20 |
Sentara Setting Facility Modifier None Typical Low $15.14 Median $281.84 Typical High $2,454.71 | Facility | None | $15.14 | $281.84 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $72.44 Median $91.20 Typical High $204.17 | Professional | None | $72.44 | $91.20 | $204.17 |
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 $12.59 Median $51.29 Typical High $125.89 | Professional | None | $12.59 | $51.29 | $125.89 |
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 $7.94 Median $29.51 Typical High $44.67 | Professional | 52 · Reduced service | $7.94 | $29.51 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.16 Median $11.75 Typical High $17.78 | Professional | 53 · Discontinued | $3.16 | $11.75 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.34 Median $8.71 Typical High $13.49 | Professional | 55 · Aftercare only | $2.34 | $8.71 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.58 Median $5.89 Typical High $8.91 | Professional | 56 · Pre-op care only | $1.58 | $5.89 | $8.91 |
Where Virginia sits
The same service costs 5.9 times more in Iowa than in Kentucky. 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· 50th of 51
$20.42
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.