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 $75.86 Median $117.49 Typical High $194.98 | Facility | None | $75.86 | $117.49 | $194.98 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $95.50 Typical High $117.49 | Professional | None | $75.86 | $95.50 | $117.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $75.86 Median $89.13 Typical High $107.15 | Professional | None | $75.86 | $89.13 | $107.15 |
CareFirst Setting Professional Modifier None Typical Low $81.28 Median $91.20 Typical High $107.15 | Professional | None | $81.28 | $91.20 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $93.33 Typical High $147.91 | Professional | None | $79.43 | $93.33 | $147.91 |
Kaiser Permanente Setting Professional Modifier None Typical Low $79.43 Median $87.10 Typical High $144.54 | Professional | None | $79.43 | $87.10 | $144.54 |
Medcost Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Medcost Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $162.18 | Facility | None | $125.89 | $125.89 | $162.18 |
Medcost Setting Professional Modifier None Typical Low $64.57 Median $109.65 Typical High $109.65 | Professional | None | $64.57 | $109.65 | $109.65 |
Sentara Setting Facility Modifier None Typical Low $69.18 Median $107.15 Typical High $218.78 | Facility | None | $69.18 | $107.15 | $218.78 |
Sentara Setting Professional Modifier None Typical Low $63.10 Median $107.15 Typical High $173.78 | Professional | None | $63.10 | $107.15 | $173.78 |
United Setting Professional Modifier None Typical Low $69.18 Median $112.20 Typical High $173.78 | Professional | None | $69.18 | $112.20 | $173.78 |
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 $38.02 Median $47.86 Typical High $47.86 | Professional | 52 · Reduced service | $38.02 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $19.05 Typical High $19.05 | Professional | 53 · Discontinued | $15.14 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $14.45 Typical High $14.45 | Professional | 55 · Aftercare only | $11.48 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $9.55 Typical High $9.55 | Professional | 56 · Pre-op care only | $7.59 | $9.55 | $9.55 |
Where Virginia sits
The same service costs 2.9 times more in Alaska than in Utah. 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
$91.20
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.