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 $46.77 Median $51.29 Typical High $144.54 | Facility | None | $46.77 | $51.29 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $81.28 Typical High $144.54 | Professional | None | $46.77 | $81.28 | $144.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $42.66 Median $102.33 Typical High $158.49 | Professional | None | $42.66 | $102.33 | $158.49 |
CareFirst Setting Professional Modifier None Typical Low $43.65 Median $48.98 Typical High $57.54 | Professional | None | $43.65 | $48.98 | $57.54 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $251.19 Typical High $691.83 | Facility | None | $112.20 | $251.19 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $114.82 Typical High $165.96 | Professional | None | $44.67 | $114.82 | $165.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $151.36 Typical High $199.53 | Professional | None | $128.82 | $151.36 | $199.53 |
Medcost Setting Professional Modifier None Typical Low $154.88 Median $190.55 Typical High $218.78 | Professional | None | $154.88 | $190.55 | $218.78 |
Medcost Setting Facility Modifier None Typical Low $60.26 Median $83.18 Typical High $223.87 | Facility | None | $60.26 | $83.18 | $223.87 |
Medcost Setting Professional Modifier None Typical Low $79.43 Median $89.13 Typical High $162.18 | Professional | None | $79.43 | $89.13 | $162.18 |
Sentara Setting Facility Modifier None Typical Low $33.11 Median $60.26 Typical High $10,232.93 | Facility | None | $33.11 | $60.26 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $117.49 Median $162.18 Typical High $239.88 | Professional | None | $117.49 | $162.18 | $239.88 |
United Setting Facility Modifier None Typical Low $398.11 Median $446.68 Typical High $977.24 | Facility | None | $398.11 | $446.68 | $977.24 |
United Setting Professional Modifier None Typical Low $37.15 Median $83.18 Typical High $186.21 | Professional | None | $37.15 | $83.18 | $186.21 |
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 $23.44 Median $39.81 Typical High $72.44 | Professional | 52 · Reduced service | $23.44 | $39.81 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $15.85 Typical High $29.51 | Professional | 53 · Discontinued | $9.33 | $15.85 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $11.75 Typical High $21.88 | Professional | 55 · Aftercare only | $6.92 | $11.75 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $7.94 Typical High $14.45 | Professional | 56 · Pre-op care only | $4.68 | $7.94 | $14.45 |
Where Virginia sits
The same service costs 3.5 times more in Wisconsin than in Washington, DC. 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· 40th of 51
$102
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.