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 $64.57 Median $93.33 Typical High $144.54 | Facility | None | $64.57 | $93.33 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $81.28 Typical High $117.49 | Professional | None | $58.88 | $81.28 | $117.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $77.62 Median $102.33 Typical High $131.83 | Professional | None | $77.62 | $102.33 | $131.83 |
CareFirst Setting Professional Modifier None Typical Low $70.79 Median $74.13 Typical High $83.18 | Professional | None | $70.79 | $74.13 | $83.18 |
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 $70.79 Median $97.72 Typical High $128.82 | Professional | None | $70.79 | $97.72 | $128.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $97.72 Median $131.83 Typical High $169.82 | Professional | None | $97.72 | $131.83 | $169.82 |
Medcost Setting Professional Modifier None Typical Low $93.33 Median $114.82 Typical High $144.54 | Professional | None | $93.33 | $114.82 | $144.54 |
Medcost Setting Facility Modifier None Typical Low $77.62 Median $114.82 Typical High $190.55 | Facility | None | $77.62 | $114.82 | $190.55 |
Medcost Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $120.23 | Professional | None | $64.57 | $64.57 | $120.23 |
Sentara Setting Facility Modifier None Typical Low $69.18 Median $95.50 Typical High $512.86 | Facility | None | $69.18 | $95.50 | $512.86 |
Sentara Setting Professional Modifier None Typical Low $102.33 Median $112.20 Typical High $154.88 | Professional | None | $102.33 | $112.20 | $154.88 |
United Setting Professional Modifier None Typical Low $56.23 Median $87.10 Typical High $134.90 | Professional | None | $56.23 | $87.10 | $134.90 |
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 $38.02 Median $41.69 Typical High $54.95 | Professional | 52 · Reduced service | $38.02 | $41.69 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $12.30 Typical High $16.22 | Professional | 55 · Aftercare only | $11.22 | $12.30 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $8.32 Typical High $10.96 | Professional | 56 · Pre-op care only | $7.59 | $8.32 | $10.96 |
Where Virginia sits
The same service costs 2.3 times more in Alaska than in Alabama. 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· 30th of 51
$95.50
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.