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 $47.86 Median $61.66 Typical High $134.90 | Facility | None | $47.86 | $61.66 | $134.90 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $74.13 Typical High $134.90 | Professional | None | $47.86 | $74.13 | $134.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $50.12 Median $87.10 Typical High $134.90 | Professional | None | $50.12 | $87.10 | $134.90 |
CareFirst Setting Professional Modifier None Typical Low $42.66 Median $47.86 Typical High $47.86 | Professional | None | $42.66 | $47.86 | $47.86 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $75.86 Typical High $100.00 | Professional | None | $39.81 | $75.86 | $100.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $95.50 Median $107.15 Typical High $134.90 | Professional | None | $95.50 | $107.15 | $134.90 |
Medcost Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $120.23 | Professional | None | $114.82 | $114.82 | $120.23 |
Medcost Setting Facility Modifier None Typical Low $75.86 Median $100.00 Typical High $190.55 | Facility | None | $75.86 | $100.00 | $190.55 |
Medcost Setting Professional Modifier None Typical Low $70.79 Median $93.33 Typical High $93.33 | Professional | None | $70.79 | $93.33 | $93.33 |
Sentara Setting Facility Modifier None Typical Low $38.02 Median $72.44 Typical High $10,232.93 | Facility | None | $38.02 | $72.44 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $63.10 Median $100.00 Typical High $128.82 | Professional | None | $63.10 | $100.00 | $128.82 |
United Setting Facility Modifier None Typical Low $851.14 Median $933.25 Typical High $2,089.30 | Facility | None | $851.14 | $933.25 | $2,089.30 |
United Setting Professional Modifier None Typical Low $35.48 Median $54.95 Typical High $85.11 | Professional | None | $35.48 | $54.95 | $85.11 |
5 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 $23.99 Median $34.67 Typical High $67.61 | Professional | 52 · Reduced service | $23.99 | $34.67 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $14.13 Typical High $26.92 | Professional | 53 · Discontinued | $9.55 | $14.13 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $10.47 Typical High $19.95 | Professional | 55 · Aftercare only | $7.24 | $10.47 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $7.08 Typical High $13.49 | Professional | 56 · Pre-op care only | $4.79 | $7.08 | $13.49 |
United Setting Professional Modifier XC Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | XC | $501.19 | $501.19 | $501.19 |
Where Virginia sits
The same service costs 2.8 times more in Alaska than in Maryland. 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· 45th of 51
$66.07
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.