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 $50.12 Median $66.07 Typical High $109.65 | Facility | None | $50.12 | $66.07 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $70.79 Typical High $120.23 | Professional | None | $50.12 | $70.79 | $120.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $54.95 Median $89.13 Typical High $165.96 | Professional | None | $54.95 | $89.13 | $165.96 |
CareFirst Setting Professional Modifier None Typical Low $64.57 Median $72.44 Typical High $72.44 | Professional | None | $64.57 | $72.44 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $74.13 Typical High $123.03 | Professional | None | $50.12 | $74.13 | $123.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $123.03 Median $138.04 Typical High $173.78 | Professional | None | $123.03 | $138.04 | $173.78 |
Medcost Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $144.54 | Professional | None | $131.83 | $131.83 | $144.54 |
Medcost Setting Facility Modifier None Typical Low $102.33 Median $144.54 Typical High $229.09 | Facility | None | $102.33 | $144.54 | $229.09 |
Medcost Setting Professional Modifier None Typical Low $58.88 Median $95.50 Typical High $112.20 | Professional | None | $58.88 | $95.50 | $112.20 |
Sentara Setting Facility Modifier None Typical Low $47.86 Median $102.33 Typical High $10,232.93 | Facility | None | $47.86 | $102.33 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $70.79 Median $117.49 Typical High $151.36 | Professional | None | $70.79 | $117.49 | $151.36 |
United Setting Facility Modifier None Typical Low $251.19 Median $275.42 Typical High $616.60 | Facility | None | $251.19 | $275.42 | $616.60 |
United Setting Professional Modifier None Typical Low $50.12 Median $69.18 Typical High $104.71 | Professional | None | $50.12 | $69.18 | $104.71 |
3 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 $25.12 Median $33.11 Typical High $54.95 | Professional | 52 · Reduced service | $25.12 | $33.11 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $9.77 Typical High $16.22 | Professional | 55 · Aftercare only | $7.59 | $9.77 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $6.61 Typical High $10.96 | Professional | 56 · Pre-op care only | $5.01 | $6.61 | $10.96 |
Where Virginia sits
The same service costs 4.3 times more in Alaska than in North Carolina. 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· 36th of 51
$87.10
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.