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 $8.71 Median $5,495.41 Typical High $14,125.38 | Facility | None | $8.71 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $7.24 Median $8.71 Typical High $8.71 | Professional | None | $7.24 | $8.71 | $8.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.24 Median $8.51 Typical High $10.96 | Professional | None | $7.24 | $8.51 | $10.96 |
CareFirst Setting Professional Modifier None Typical Low $7.76 Median $8.51 Typical High $10.23 | Professional | None | $7.76 | $8.51 | $10.23 |
Cigna Setting Facility Modifier None Typical Low $4.07 Median $4.68 Typical High $186.21 | Facility | None | $4.07 | $4.68 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $7.59 Median $8.71 Typical High $15.85 | Professional | None | $7.59 | $8.71 | $15.85 |
Kaiser Permanente Setting Professional Modifier None Typical Low $6.61 Median $8.71 Typical High $12.59 | Professional | None | $6.61 | $8.71 | $12.59 |
Medcost Setting Professional Modifier None Typical Low $15.85 Median $19.95 Typical High $19.95 | Professional | None | $15.85 | $19.95 | $19.95 |
Medcost Setting Facility Modifier None Typical Low $13.80 Median $13.80 Typical High $14.79 | Facility | None | $13.80 | $13.80 | $14.79 |
Medcost Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $36.31 | Professional | None | $32.36 | $32.36 | $36.31 |
Sentara Setting Facility Modifier None Typical Low $1.78 Median $7.94 Typical High $30.20 | Facility | None | $1.78 | $7.94 | $30.20 |
Sentara Setting Professional Modifier None Typical Low $1.91 Median $8.32 Typical High $13.80 | Professional | None | $1.91 | $8.32 | $13.80 |
United Setting Facility Modifier None Typical Low $245.47 Median $269.15 Typical High $602.56 | Facility | None | $245.47 | $269.15 | $602.56 |
United Setting Professional Modifier None Typical Low $6.61 Median $9.12 Typical High $16.98 | Professional | None | $6.61 | $9.12 | $16.98 |
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 $3.63 Median $4.37 Typical High $4.37 | Professional | 52 · Reduced service | $3.63 | $4.37 | $4.37 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.45 Median $1.74 Typical High $1.74 | Professional | 53 · Discontinued | $1.45 | $1.74 | $1.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $5.37 Median $6.46 Typical High $6.46 | Professional | 54 · Surgery only | $5.37 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.07 Median $1.29 Typical High $1.29 | Professional | 55 · Aftercare only | $1.07 | $1.29 | $1.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.72 Median $0.85 Typical High $0.85 | Professional | 56 · Pre-op care only | $0.72 | $0.85 | $0.85 |
Where Virginia sits
The same service costs 2.3 times more in Hawaii than in North Carolina. 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
$8.51
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.