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 $38.90 Median $61.66 Typical High $97.72 | Facility | None | $38.90 | $61.66 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $56.23 Typical High $75.86 | Professional | None | $37.15 | $56.23 | $75.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $45.71 Median $63.10 Typical High $87.10 | Professional | None | $45.71 | $63.10 | $87.10 |
CareFirst Setting Professional Modifier None Typical Low $39.81 Median $42.66 Typical High $50.12 | Professional | None | $39.81 | $42.66 | $50.12 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $147.91 Typical High $204.17 | Facility | None | $120.23 | $147.91 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $63.10 Typical High $89.13 | Professional | None | $39.81 | $63.10 | $89.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $63.10 Median $85.11 Typical High $109.65 | Professional | None | $63.10 | $85.11 | $109.65 |
Medcost Setting Professional Modifier None Typical Low $61.66 Median $79.43 Typical High $97.72 | Professional | None | $61.66 | $79.43 | $97.72 |
Medcost Setting Facility Modifier None Typical Low $45.71 Median $77.62 Typical High $128.82 | Facility | None | $45.71 | $77.62 | $128.82 |
Medcost Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $83.18 | Professional | None | $46.77 | $46.77 | $83.18 |
Sentara Setting Facility Modifier None Typical Low $45.71 Median $60.26 Typical High $380.19 | Facility | None | $45.71 | $60.26 | $380.19 |
Sentara Setting Professional Modifier None Typical Low $69.18 Median $74.13 Typical High $100.00 | Professional | None | $69.18 | $74.13 | $100.00 |
United Setting Professional Modifier None Typical Low $37.15 Median $58.88 Typical High $91.20 | Professional | None | $37.15 | $58.88 | $91.20 |
3 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 $22.91 Median $26.92 Typical High $37.15 | Professional | 52 · Reduced service | $22.91 | $26.92 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $8.13 Typical High $11.22 | Professional | 55 · Aftercare only | $6.76 | $8.13 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $5.37 Typical High $7.59 | Professional | 56 · Pre-op care only | $4.57 | $5.37 | $7.59 |
Where Virginia sits
The same service costs 2.2 times more in Alaska than in New Jersey. 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· 35th of 51
$60.26
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.