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 $21.38 Median $29.51 Typical High $53.70 | Facility | None | $21.38 | $29.51 | $53.70 |
Aetna Setting Professional Modifier None Typical Low $21.38 Median $46.77 Typical High $53.70 | Professional | None | $21.38 | $46.77 | $53.70 |
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 $25.12 Median $45.71 Typical High $75.86 | Professional | None | $25.12 | $45.71 | $75.86 |
CareFirst Setting Professional Modifier None Typical Low $25.70 Median $28.18 Typical High $691.83 | Professional | None | $25.70 | $28.18 | $691.83 |
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 $24.55 Median $50.12 Typical High $85.11 | Professional | None | $24.55 | $50.12 | $85.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $21.88 Median $61.66 Typical High $75.86 | Professional | None | $21.88 | $61.66 | $75.86 |
Medcost Setting Professional Modifier None Typical Low $81.28 Median $102.33 Typical High $102.33 | Professional | None | $81.28 | $102.33 | $102.33 |
Medcost Setting Facility Modifier None Typical Low $29.51 Median $47.86 Typical High $89.13 | Facility | None | $29.51 | $47.86 | $89.13 |
Medcost Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Sentara Setting Facility Modifier None Typical Low $26.92 Median $218.78 Typical High $2,454.71 | Facility | None | $26.92 | $218.78 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $50.12 Median $67.61 Typical High $870.96 | Professional | None | $50.12 | $67.61 | $870.96 |
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 $23.99 Median $47.86 Typical High $97.72 | Professional | None | $23.99 | $47.86 | $97.72 |
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 $10.72 Median $19.05 Typical High $26.92 | Professional | 52 · Reduced service | $10.72 | $19.05 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.27 Median $9.12 Typical High $10.72 | Professional | 53 · Discontinued | $4.27 | $9.12 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $6.92 Typical High $8.13 | Professional | 55 · Aftercare only | $3.16 | $6.92 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.14 Median $4.57 Typical High $5.37 | Professional | 56 · Pre-op care only | $2.14 | $4.57 | $5.37 |
Where Virginia sits
The same service costs 3.5 times more in Wisconsin than in Utah. 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· 42nd of 51
$52.48
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.