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 $54.95 Median $72.44 Typical High $154.88 | Facility | None | $54.95 | $72.44 | $154.88 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $89.13 Typical High $154.88 | Professional | None | $54.95 | $89.13 | $154.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $58.88 Median $102.33 Typical High $162.18 | Professional | None | $58.88 | $102.33 | $162.18 |
CareFirst Setting Professional Modifier None Typical Low $52.48 Median $57.54 Typical High $57.54 | Professional | None | $52.48 | $57.54 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $87.10 Typical High $120.23 | Professional | None | $45.71 | $87.10 | $120.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $109.65 Median $123.03 Typical High $154.88 | Professional | None | $109.65 | $123.03 | $154.88 |
Medcost Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $141.25 | Professional | None | $128.82 | $128.82 | $141.25 |
Medcost Setting Facility Modifier None Typical Low $89.13 Median $117.49 Typical High $218.78 | Facility | None | $89.13 | $117.49 | $218.78 |
Medcost Setting Professional Modifier None Typical Low $89.13 Median $104.71 Typical High $104.71 | Professional | None | $89.13 | $104.71 | $104.71 |
Sentara Setting Facility Modifier None Typical Low $44.67 Median $83.18 Typical High $10,232.93 | Facility | None | $44.67 | $83.18 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $69.18 Median $112.20 Typical High $147.91 | Professional | None | $69.18 | $112.20 | $147.91 |
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 $40.74 Median $63.10 Typical High $97.72 | Professional | None | $40.74 | $63.10 | $97.72 |
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 $27.54 Median $39.81 Typical High $77.62 | Professional | 52 · Reduced service | $27.54 | $39.81 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $16.22 Typical High $30.90 | Professional | 53 · Discontinued | $10.96 | $16.22 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $12.02 Typical High $23.44 | Professional | 55 · Aftercare only | $8.32 | $12.02 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $7.94 Typical High $15.49 | Professional | 56 · Pre-op care only | $5.50 | $7.94 | $15.49 |
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· 41st of 51
$79.43
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.