How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $54.95 Median $54.95 Typical High $72.44 | Facility | None | $54.95 | $54.95 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $72.44 | Professional | None | $54.95 | $54.95 | $72.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $66.07 Median $75.86 Typical High $85.11 | Professional | None | $66.07 | $75.86 | $85.11 |
CareFirst Setting Professional Modifier None Typical Low $60.26 Median $66.07 Typical High $66.07 | Professional | None | $60.26 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $74.13 Typical High $107.15 | Professional | None | $58.88 | $74.13 | $107.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $54.95 Median $70.79 Typical High $102.33 | Professional | None | $54.95 | $70.79 | $102.33 |
Medcost Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $93.33 | Facility | None | $72.44 | $72.44 | $93.33 |
Medcost Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $61.66 | Professional | None | $42.66 | $42.66 | $61.66 |
United Setting Professional Modifier None Typical Low $50.12 Median $75.86 Typical High $112.20 | Professional | None | $50.12 | $75.86 | $112.20 |
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 $27.54 Median $27.54 Typical High $36.31 | Professional | 52 · Reduced service | $27.54 | $27.54 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $10.96 Typical High $14.45 | Professional | 53 · Discontinued | $10.96 | $10.96 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.32 Typical High $10.96 | Professional | 55 · Aftercare only | $8.32 | $8.32 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.50 Typical High $7.24 | Professional | 56 · Pre-op care only | $5.50 | $5.50 | $7.24 |
Where Virginia sits
The same service costs 3.2 times more in Alaska than in Kentucky. 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· 19th of 51
$74.13
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.