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 $10.00 Median $10.00 Typical High $15.85 | Facility | None | $10.00 | $10.00 | $15.85 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $11.22 Typical High $15.85 | Professional | None | $10.00 | $11.22 | $15.85 |
Anthem BCBS Setting Professional Modifier None Typical Low $11.22 Median $14.13 Typical High $15.85 | Professional | None | $11.22 | $14.13 | $15.85 |
CareFirst Setting Professional Modifier None Typical Low $10.00 Median $11.22 Typical High $11.22 | Professional | None | $10.00 | $11.22 | $11.22 |
Cigna Setting Professional Modifier None Typical Low $9.12 Median $9.12 Typical High $16.22 | Professional | None | $9.12 | $9.12 | $16.22 |
Kaiser Permanente Setting Professional Modifier None Typical Low $12.59 Median $14.13 Typical High $17.78 | Professional | None | $12.59 | $14.13 | $17.78 |
Medcost Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $36.31 | Professional | None | $33.11 | $33.11 | $36.31 |
Medcost Setting Facility Modifier None Typical Low $19.05 Median $19.05 Typical High $20.89 | Facility | None | $19.05 | $19.05 | $20.89 |
Medcost Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | None | $12.88 | $12.88 | $12.88 |
Sentara Setting Facility Modifier None Typical Low $11.22 Median $19.50 Typical High $10,232.93 | Facility | None | $11.22 | $19.50 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $9.77 Median $14.13 Typical High $21.88 | Professional | None | $9.77 | $14.13 | $21.88 |
United Setting Facility Modifier None Typical Low $112.20 Median $123.03 Typical High $275.42 | Facility | None | $112.20 | $123.03 | $275.42 |
United Setting Professional Modifier None Typical Low $7.24 Median $7.94 Typical High $18.20 | Professional | None | $7.24 | $7.94 | $18.20 |
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 $5.01 Median $5.62 Typical High $7.76 | Professional | 52 · Reduced service | $5.01 | $5.62 | $7.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.00 Median $2.24 Typical High $3.16 | Professional | 53 · Discontinued | $2.00 | $2.24 | $3.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.48 Median $1.70 Typical High $2.34 | Professional | 55 · Aftercare only | $1.48 | $1.70 | $2.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.00 Median $1.12 Typical High $1.58 | Professional | 56 · Pre-op care only | $1.00 | $1.12 | $1.58 |
Where Virginia sits
The same service costs 3.2 times more in Alaska than in Florida. 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· 35th of 51
$11.75
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.