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 $21.38 Median $3,801.89 Typical High $9,332.54 | Facility | None | $21.38 | $3,801.89 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $22.39 Typical High $5,248.07 | Professional | None | $18.20 | $22.39 | $5,248.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $17.38 Median $20.89 Typical High $24.55 | Professional | None | $17.38 | $20.89 | $24.55 |
CareFirst Setting Professional Modifier None Typical Low $18.20 Median $19.95 Typical High $19.95 | Professional | None | $18.20 | $19.95 | $19.95 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $53.70 Typical High $117.49 | Facility | None | $33.11 | $53.70 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $21.88 Typical High $50.12 | Professional | None | $17.78 | $21.88 | $50.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $18.62 Median $26.30 Typical High $27.54 | Professional | None | $18.62 | $26.30 | $27.54 |
Medcost Setting Facility Modifier None Typical Low $36.31 Median $257.04 Typical High $257.04 | Facility | None | $36.31 | $257.04 | $257.04 |
Sentara Setting Facility Modifier None Typical Low $18.62 Median $30.20 Typical High $10,232.93 | Facility | None | $18.62 | $30.20 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $18.62 Median $30.20 Typical High $10,232.93 | Professional | None | $18.62 | $30.20 | $10,232.93 |
United Setting Facility Modifier None Typical Low $89.13 Median $97.72 Typical High $218.78 | Facility | None | $89.13 | $97.72 | $218.78 |
United Setting Professional Modifier None Typical Low $18.62 Median $30.20 Typical High $40.74 | Professional | None | $18.62 | $30.20 | $40.74 |
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 $9.12 Median $9.55 Typical High $10.72 | Professional | 52 · Reduced service | $9.12 | $9.55 | $10.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $3.89 Typical High $4.27 | Professional | 53 · Discontinued | $3.63 | $3.89 | $4.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $2.88 Typical High $3.24 | Professional | 55 · Aftercare only | $2.75 | $2.88 | $3.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $1.91 Typical High $2.14 | Professional | 56 · Pre-op care only | $1.82 | $1.91 | $2.14 |
Where Virginia sits
The same service costs 40.7 times more in Tennessee than in New York. 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· 46th of 51
$22.91
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.