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 $26.30 Median $26.30 Typical High $27.54 | Facility | None | $26.30 | $26.30 | $27.54 |
Aetna Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $27.54 | Professional | None | $26.30 | $26.30 | $27.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.12 Median $30.20 Typical High $38.02 | Professional | None | $25.12 | $30.20 | $38.02 |
CareFirst Setting Professional Modifier None Typical Low $28.84 Median $31.62 Typical High $38.02 | Professional | None | $28.84 | $31.62 | $38.02 |
Cigna Setting Facility Modifier None Typical Low $44.67 Median $51.29 Typical High $154.88 | Facility | None | $44.67 | $51.29 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $30.20 Typical High $54.95 | Professional | None | $25.70 | $30.20 | $54.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $26.30 Median $31.62 Typical High $42.66 | Professional | None | $26.30 | $31.62 | $42.66 |
Medcost Setting Professional Modifier None Typical Low $34.67 Median $57.54 Typical High $57.54 | Professional | None | $34.67 | $57.54 | $57.54 |
Medcost Setting Facility Modifier None Typical Low $45.71 Median $47.86 Typical High $47.86 | Facility | None | $45.71 | $47.86 | $47.86 |
Medcost Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $29.51 | Professional | None | $27.54 | $27.54 | $29.51 |
Sentara Setting Facility Modifier None Typical Low $6.61 Median $13.18 Typical High $10,232.93 | Facility | None | $6.61 | $13.18 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $4.79 Median $7.76 Typical High $30.20 | Professional | None | $4.79 | $7.76 | $30.20 |
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 $21.38 Median $30.90 Typical High $58.88 | Professional | None | $21.38 | $30.90 | $58.88 |
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 $13.18 Median $13.18 Typical High $13.80 | Professional | 52 · Reduced service | $13.18 | $13.18 | $13.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $5.25 Typical High $5.50 | Professional | 53 · Discontinued | $5.25 | $5.25 | $5.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $3.98 Typical High $4.07 | Professional | 55 · Aftercare only | $3.98 | $3.98 | $4.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $2.63 Typical High $2.75 | Professional | 56 · Pre-op care only | $2.63 | $2.63 | $2.75 |
Where Virginia sits
The same service costs 2.5 times more in Minnesota than in Arkansas. 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
$28.84
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.