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 $251.19 Median $251.19 Typical High $275.42 | Facility | None | $251.19 | $251.19 | $275.42 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $275.42 Typical High $363.08 | Professional | None | $251.19 | $275.42 | $363.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $269.15 Median $316.23 Typical High $380.19 | Professional | None | $269.15 | $316.23 | $380.19 |
CareFirst Setting Professional Modifier None Typical Low $302.00 Median $338.84 Typical High $389.05 | Professional | None | $302.00 | $338.84 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $691.83 | Facility | None | $588.84 | $588.84 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $295.12 Typical High $380.19 | Professional | None | $245.47 | $295.12 | $380.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $302.00 Median $338.84 Typical High $446.68 | Professional | None | $302.00 | $338.84 | $446.68 |
Medcost Setting Professional Modifier None Typical Low $269.15 Median $338.84 Typical High $346.74 | Professional | None | $269.15 | $338.84 | $346.74 |
Medcost Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $436.52 | Facility | None | $323.59 | $323.59 | $436.52 |
Medcost Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $263.03 | Professional | None | $177.83 | $177.83 | $263.03 |
Sentara Setting Facility Modifier None Typical Low $213.80 Median $338.84 Typical High $10,232.93 | Facility | None | $213.80 | $338.84 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $245.47 Median $281.84 Typical High $436.52 | Professional | None | $245.47 | $281.84 | $436.52 |
United Setting Professional Modifier None Typical Low $173.78 Median $223.87 Typical High $371.54 | Professional | None | $173.78 | $223.87 | $371.54 |
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 $125.89 Median $138.04 Typical High $138.04 | Professional | 52 · Reduced service | $125.89 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $54.95 Typical High $54.95 | Professional | 53 · Discontinued | $50.12 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $40.74 Typical High $40.74 | Professional | 55 · Aftercare only | $38.02 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $27.54 Typical High $27.54 | Professional | 56 · Pre-op care only | $25.12 | $27.54 | $27.54 |
Where Virginia sits
The same service costs 2.8 times more in Alaska than in New York. 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· 28th of 51
$302
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.