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 $83.18 Median $83.18 Typical High $87.10 | Facility | None | $83.18 | $83.18 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $87.10 | Professional | None | $83.18 | $83.18 | $87.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $69.18 Median $83.18 Typical High $97.72 | Professional | None | $69.18 | $83.18 | $97.72 |
CareFirst Setting Professional Modifier None Typical Low $77.62 Median $85.11 Typical High $100.00 | Professional | None | $77.62 | $85.11 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $154.88 Typical High $218.78 | Facility | None | $53.70 | $154.88 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $75.86 Typical High $117.49 | Professional | None | $67.61 | $75.86 | $117.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $74.13 Median $89.13 Typical High $120.23 | Professional | None | $74.13 | $89.13 | $120.23 |
Medcost Setting Professional Modifier None Typical Low $79.43 Median $100.00 Typical High $120.23 | Professional | None | $79.43 | $100.00 | $120.23 |
Medcost Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $144.54 | Facility | None | $109.65 | $109.65 | $144.54 |
Medcost Setting Professional Modifier None Typical Low $25.12 Median $39.81 Typical High $114.82 | Professional | None | $25.12 | $39.81 | $114.82 |
Sentara Setting Facility Modifier None Typical Low $51.29 Median $102.33 Typical High $10,232.93 | Facility | None | $51.29 | $102.33 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $16.98 Median $104.71 Typical High $162.18 | Professional | None | $16.98 | $104.71 | $162.18 |
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 $63.10 Median $79.43 Typical High $131.83 | Professional | None | $63.10 | $79.43 | $131.83 |
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 $41.69 Median $41.69 Typical High $43.65 | Professional | 52 · Reduced service | $41.69 | $41.69 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $16.60 Typical High $17.38 | Professional | 53 · Discontinued | $16.60 | $16.60 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $12.30 Typical High $13.18 | Professional | 55 · Aftercare only | $12.30 | $12.30 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $8.71 | Professional | 56 · Pre-op care only | $8.32 | $8.32 | $8.71 |
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· 36th of 51
$83.18
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.