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 $75.86 Median $75.86 Typical High $81.28 | Facility | None | $75.86 | $75.86 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $75.86 Typical High $81.28 | Professional | None | $74.13 | $75.86 | $81.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $741.31 Typical High $933.25 | Facility | None | $575.44 | $741.31 | $933.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $63.10 | Professional | None | $38.90 | $38.90 | $63.10 |
CareFirst Setting Professional Modifier None Typical Low $67.61 Median $75.86 Typical High $97.72 | Professional | None | $67.61 | $75.86 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $134.90 Typical High $147.91 | Facility | None | $87.10 | $134.90 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $50.12 Typical High $151.36 | Professional | None | $41.69 | $50.12 | $151.36 |
Kaiser Permanente Setting Professional Modifier None Typical Low $97.72 Median $104.71 Typical High $128.82 | Professional | None | $97.72 | $104.71 | $128.82 |
Medcost Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $123.03 | Facility | None | $117.49 | $117.49 | $123.03 |
Medcost Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
Sentara Setting Facility Modifier None Typical Low $64.57 Median $112.20 Typical High $10,232.93 | Facility | None | $64.57 | $112.20 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $158.49 | Professional | None | $95.50 | $95.50 | $158.49 |
United Setting Facility Modifier None Typical Low $323.59 Median $354.81 Typical High $794.33 | Facility | None | $323.59 | $354.81 | $794.33 |
United Setting Professional Modifier None Typical Low $60.26 Median $100.00 Typical High $194.98 | Professional | None | $60.26 | $100.00 | $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 $38.02 Median $38.02 Typical High $40.74 | Professional | 52 · Reduced service | $38.02 | $38.02 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.49 Typical High $16.22 | Professional | 53 · Discontinued | $15.14 | $15.49 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.48 Typical High $12.30 | Professional | 55 · Aftercare only | $11.22 | $11.48 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $8.13 | Professional | 56 · Pre-op care only | $7.59 | $7.59 | $8.13 |
Where Virginia sits
The same service costs 5.0 times more in Alaska than in Alabama. 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· 44th of 51
$75.86
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.