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 $120.23 Median $138.04 Typical High $275.42 | Facility | None | $120.23 | $138.04 | $275.42 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $138.04 Typical High $138.04 | Professional | None | $120.23 | $138.04 | $138.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $112.20 Median $134.90 Typical High $162.18 | Professional | None | $112.20 | $134.90 | $162.18 |
CareFirst Setting Professional Modifier None Typical Low $104.71 Median $114.82 Typical High $114.82 | Professional | None | $104.71 | $114.82 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $416.87 Typical High $426.58 | Facility | None | $354.81 | $416.87 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $123.03 Typical High $213.80 | Professional | None | $104.71 | $123.03 | $213.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $109.65 Median $138.04 Typical High $158.49 | Professional | None | $109.65 | $138.04 | $158.49 |
Medcost Setting Professional Modifier None Typical Low $120.23 Median $169.82 Typical High $190.55 | Professional | None | $120.23 | $169.82 | $190.55 |
Medcost Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $234.42 | Facility | None | $208.93 | $208.93 | $234.42 |
Sentara Setting Facility Modifier None Typical Low $95.50 Median $165.96 Typical High $10,232.93 | Facility | None | $95.50 | $165.96 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $89.13 Median $123.03 Typical High $229.09 | Professional | None | $89.13 | $123.03 | $229.09 |
United Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
United Setting Professional Modifier None Typical Low $97.72 Median $123.03 Typical High $223.87 | Professional | None | $97.72 | $123.03 | $223.87 |
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 $60.26 Median $69.18 Typical High $69.18 | Professional | 52 · Reduced service | $60.26 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $27.54 Typical High $27.54 | Professional | 53 · Discontinued | $23.99 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $20.89 Typical High $20.89 | Professional | 55 · Aftercare only | $17.78 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $13.80 Typical High $13.80 | Professional | 56 · Pre-op care only | $12.02 | $13.80 | $13.80 |
Where Virginia sits
The same service costs 2.8 times more in Alaska than in Indiana. 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· 34th of 51
$132
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.