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 $114.82 Median $117.49 Typical High $239.88 | Facility | None | $114.82 | $117.49 | $239.88 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $117.49 | Professional | None | $114.82 | $114.82 | $117.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $95.50 Median $109.65 Typical High $128.82 | Professional | None | $95.50 | $109.65 | $128.82 |
CareFirst Setting Professional Modifier None Typical Low $109.65 Median $120.23 Typical High $141.25 | Professional | None | $109.65 | $120.23 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $257.04 Median $398.11 Typical High $1,096.48 | Facility | None | $257.04 | $398.11 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $107.15 Typical High $162.18 | Professional | None | $95.50 | $107.15 | $162.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $102.33 Median $123.03 Typical High $165.96 | Professional | None | $102.33 | $123.03 | $165.96 |
Medcost Setting Professional Modifier None Typical Low $112.20 Median $141.25 Typical High $169.82 | Professional | None | $112.20 | $141.25 | $169.82 |
Medcost Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $186.21 | Facility | None | $151.36 | $151.36 | $186.21 |
Medcost Setting Professional Modifier None Typical Low $64.57 Median $100.00 Typical High $162.18 | Professional | None | $64.57 | $100.00 | $162.18 |
Sentara Setting Facility Modifier None Typical Low $75.86 Median $147.91 Typical High $10,232.93 | Facility | None | $75.86 | $147.91 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $43.65 Median $141.25 Typical High $218.78 | Professional | None | $43.65 | $141.25 | $218.78 |
United Setting Facility Modifier None Typical Low $630.96 Median $691.83 Typical High $1,548.82 | Facility | None | $630.96 | $691.83 | $1,548.82 |
United Setting Professional Modifier None Typical Low $83.18 Median $107.15 Typical High $177.83 | Professional | None | $83.18 | $107.15 | $177.83 |
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 $57.54 Median $57.54 Typical High $58.88 | Professional | 52 · Reduced service | $57.54 | $57.54 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $22.91 Typical High $23.44 | Professional | 53 · Discontinued | $22.91 | $22.91 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | 55 · Aftercare only | $17.38 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.48 Typical High $11.75 | Professional | 56 · Pre-op care only | $11.48 | $11.48 | $11.75 |
Where Virginia sits
The same service costs 3.0 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· 39th of 51
$115
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.