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 $85.11 Median $93.33 Typical High $138.04 | Facility | None | $85.11 | $93.33 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $117.49 Typical High $138.04 | Professional | None | $85.11 | $117.49 | $138.04 |
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 $77.62 Median $91.20 Typical High $109.65 | Professional | None | $77.62 | $91.20 | $109.65 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $114.82 Median $138.04 Typical High $165.96 | Professional | 50 · Both sides | $114.82 | $138.04 | $165.96 |
CareFirst Setting Professional Modifier None Typical Low $85.11 Median $95.50 Typical High $112.20 | Professional | None | $85.11 | $95.50 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $87.10 Typical High $162.18 | Facility | None | $50.12 | $87.10 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $120.23 Typical High $173.78 | Professional | None | $79.43 | $120.23 | $173.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $131.83 Median $158.49 Typical High $199.53 | Professional | None | $131.83 | $158.49 | $199.53 |
Medcost Setting Professional Modifier None Typical Low $151.36 Median $190.55 Typical High $190.55 | Professional | None | $151.36 | $190.55 | $190.55 |
Medcost Setting Facility Modifier None Typical Low $93.33 Median $138.04 Typical High $223.87 | Facility | None | $93.33 | $138.04 | $223.87 |
Medcost Setting Professional Modifier None Typical Low $97.72 Median $102.33 Typical High $141.25 | Professional | None | $97.72 | $102.33 | $141.25 |
Sentara Setting Facility Modifier None Typical Low $74.13 Median $371.54 Typical High $2,454.71 | Facility | None | $74.13 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $89.13 Median $141.25 Typical High $295.12 | Professional | None | $89.13 | $141.25 | $295.12 |
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 $64.57 Median $102.33 Typical High $194.98 | Professional | None | $64.57 | $102.33 | $194.98 |
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 $42.66 Median $58.88 Typical High $69.18 | Professional | 52 · Reduced service | $42.66 | $58.88 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $23.44 Typical High $27.54 | Professional | 53 · Discontinued | $16.98 | $23.44 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $17.78 Typical High $20.42 | Professional | 55 · Aftercare only | $12.59 | $17.78 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $11.75 Typical High $13.80 | Professional | 56 · Pre-op care only | $8.51 | $11.75 | $13.80 |
Where Virginia sits
The same service costs 3.5 times more in Alaska than in Maryland. 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
$97.72
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.