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 $19.05 Median $25.12 Typical High $107.15 | Facility | None | $19.05 | $25.12 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $19.05 Median $47.86 Typical High $107.15 | Professional | None | $19.05 | $47.86 | $107.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.95 Median $64.57 Typical High $107.15 | Professional | None | $19.95 | $64.57 | $107.15 |
CareFirst Setting Professional Modifier None Typical Low $17.78 Median $19.95 Typical High $19.95 | Professional | None | $17.78 | $19.95 | $19.95 |
Cigna Setting Professional Modifier None Typical Low $15.49 Median $52.48 Typical High $79.43 | Professional | None | $15.49 | $52.48 | $79.43 |
Kaiser Permanente Setting Professional Modifier None Typical Low $77.62 Median $87.10 Typical High $109.65 | Professional | None | $77.62 | $87.10 | $109.65 |
Medcost Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $74.13 | Professional | None | $64.57 | $64.57 | $74.13 |
Medcost Setting Facility Modifier None Typical Low $31.62 Median $39.81 Typical High $141.25 | Facility | None | $31.62 | $39.81 | $141.25 |
Medcost Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
Sentara Setting Facility Modifier None Typical Low $15.85 Median $28.84 Typical High $10,232.93 | Facility | None | $15.85 | $28.84 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $38.02 Median $70.79 Typical High $100.00 | Professional | None | $38.02 | $70.79 | $100.00 |
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 $14.13 Median $36.31 Typical High $61.66 | Professional | None | $14.13 | $36.31 | $61.66 |
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 $9.33 Median $23.99 Typical High $53.70 | Professional | 52 · Reduced service | $9.33 | $23.99 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.80 Median $9.55 Typical High $21.38 | Professional | 53 · Discontinued | $3.80 | $9.55 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $7.08 Typical High $16.22 | Professional | 55 · Aftercare only | $2.82 | $7.08 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.91 Median $4.79 Typical High $10.72 | Professional | 56 · Pre-op care only | $1.91 | $4.79 | $10.72 |
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 4.4 times more in Hawaii than in Washington, DC. 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· 44th of 51
$39.81
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.