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 $112.20 Median $112.20 Typical High $131.83 | Facility | None | $112.20 | $112.20 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $131.83 Typical High $204.17 | Professional | None | $112.20 | $131.83 | $204.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $112.20 Median $131.83 Typical High $158.49 | Professional | None | $112.20 | $131.83 | $158.49 |
CareFirst Setting Professional Modifier None Typical Low $131.83 Median $147.91 Typical High $169.82 | Professional | None | $131.83 | $147.91 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $363.08 | Facility | None | $316.23 | $316.23 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $120.23 Typical High $177.83 | Professional | None | $117.49 | $120.23 | $177.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $104.71 Median $114.82 Typical High $173.78 | Professional | None | $104.71 | $114.82 | $173.78 |
Medcost Setting Professional Modifier None Typical Low $141.25 Median $173.78 Typical High $181.97 | Professional | None | $141.25 | $173.78 | $181.97 |
Medcost Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $223.87 | Facility | None | $162.18 | $162.18 | $223.87 |
Medcost Setting Professional Modifier None Typical Low $117.49 Median $223.87 Typical High $263.03 | Professional | None | $117.49 | $223.87 | $263.03 |
Sentara Setting Facility Modifier None Typical Low $93.33 Median $177.83 Typical High $10,232.93 | Facility | None | $93.33 | $177.83 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $120.23 Median $134.90 Typical High $186.21 | Professional | None | $120.23 | $134.90 | $186.21 |
United Setting Professional Modifier None Typical Low $85.11 Median $114.82 Typical High $190.55 | Professional | None | $85.11 | $114.82 | $190.55 |
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 $56.23 Median $60.26 Typical High $66.07 | Professional | 52 · Reduced service | $56.23 | $60.26 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $23.99 Typical High $26.30 | Professional | 53 · Discontinued | $22.91 | $23.99 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $18.20 Typical High $19.95 | Professional | 55 · Aftercare only | $16.98 | $18.20 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $12.02 Typical High $13.18 | Professional | 56 · Pre-op care only | $11.22 | $12.02 | $13.18 |
Where Virginia sits
The same service costs 3.2 times more in Alaska 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· 32nd of 51
$132
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.