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 $20.42 Median $20.42 Typical High $20.42 | Facility | None | $20.42 | $20.42 | $20.42 |
Aetna Setting Professional Modifier None Typical Low $19.95 Median $20.42 Typical High $22.39 | Professional | None | $19.95 | $20.42 | $22.39 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.05 Median $22.91 Typical High $27.54 | Professional | None | $19.05 | $22.91 | $27.54 |
CareFirst Setting Professional Modifier None Typical Low $17.78 Median $19.95 Typical High $21.88 | Professional | None | $17.78 | $19.95 | $21.88 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $61.66 Typical High $371.54 | Facility | None | $53.70 | $61.66 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $21.38 Typical High $39.81 | Professional | None | $20.89 | $21.38 | $39.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $16.60 Median $19.50 Typical High $24.55 | Professional | None | $16.60 | $19.50 | $24.55 |
Medcost Setting Professional Modifier None Typical Low $25.70 Median $32.36 Typical High $32.36 | Professional | None | $25.70 | $32.36 | $32.36 |
Medcost Setting Facility Modifier None Typical Low $29.51 Median $29.51 Typical High $40.74 | Facility | None | $29.51 | $29.51 | $40.74 |
Medcost Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $21.38 | Professional | None | $16.98 | $16.98 | $21.38 |
Sentara Setting Facility Modifier None Typical Low $15.85 Median $28.18 Typical High $10,232.93 | Facility | None | $15.85 | $28.18 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $20.42 Median $27.54 Typical High $50.12 | Professional | None | $20.42 | $27.54 | $50.12 |
United Setting Facility Modifier None Typical Low $407.38 Median $446.68 Typical High $1,000.00 | Facility | None | $407.38 | $446.68 | $1,000.00 |
United Setting Professional Modifier None Typical Low $16.98 Median $25.12 Typical High $42.66 | Professional | None | $16.98 | $25.12 | $42.66 |
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 $10.23 Median $11.75 Typical High $11.75 | Professional | 52 · Reduced service | $10.23 | $11.75 | $11.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $4.68 Typical High $4.68 | Professional | 53 · Discontinued | $4.07 | $4.68 | $4.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $3.55 Typical High $3.55 | Professional | 55 · Aftercare only | $3.02 | $3.55 | $3.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.34 Typical High $2.34 | Professional | 56 · Pre-op care only | $2.04 | $2.34 | $2.34 |
Where Virginia sits
The same service costs 2.8 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· 38th of 51
$22.39
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.