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 $66.07 Median $95.50 Typical High $125.89 | Facility | None | $66.07 | $95.50 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $77.62 Typical High $97.72 | Professional | None | $66.07 | $77.62 | $97.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $64.57 Median $75.86 Typical High $93.33 | Professional | None | $64.57 | $75.86 | $93.33 |
CareFirst Setting Professional Modifier None Typical Low $77.62 Median $85.11 Typical High $97.72 | Professional | None | $77.62 | $85.11 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $851.14 Typical High $2,570.40 | Facility | None | $186.21 | $851.14 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $104.71 | Professional | None | $69.18 | $69.18 | $104.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $60.26 Median $66.07 Typical High $100.00 | Professional | None | $60.26 | $66.07 | $100.00 |
Medcost Setting Professional Modifier None Typical Low $83.18 Median $104.71 Typical High $107.15 | Professional | None | $83.18 | $104.71 | $107.15 |
Medcost Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $131.83 | Facility | None | $95.50 | $95.50 | $131.83 |
Medcost Setting Professional Modifier None Typical Low $70.79 Median $151.36 Typical High $223.87 | Professional | None | $70.79 | $151.36 | $223.87 |
Sentara Setting Facility Modifier None Typical Low $54.95 Median $114.82 Typical High $10,232.93 | Facility | None | $54.95 | $114.82 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $72.44 Median $79.43 Typical High $109.65 | Professional | None | $72.44 | $79.43 | $109.65 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $1,445.44 Typical High $3,162.28 | Facility | None | $1,288.25 | $1,445.44 | $3,162.28 |
United Setting Professional Modifier None Typical Low $51.29 Median $67.61 Typical High $112.20 | Professional | None | $51.29 | $67.61 | $112.20 |
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 $33.11 Median $35.48 Typical High $38.90 | Professional | 52 · Reduced service | $33.11 | $35.48 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $14.13 Typical High $15.49 | Professional | 53 · Discontinued | $13.18 | $14.13 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.47 Typical High $11.75 | Professional | 55 · Aftercare only | $10.00 | $10.47 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $7.08 Typical High $7.76 | Professional | 56 · Pre-op care only | $6.61 | $7.08 | $7.76 |
Where Virginia sits
The same service costs 3.2 times more in Alaska than in Florida. 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· 33rd of 51
$77.62
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.