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 $107.15 Median $151.36 Typical High $245.47 | Facility | None | $107.15 | $151.36 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $128.82 Typical High $186.21 | Professional | None | $97.72 | $128.82 | $186.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $154.88 Typical High $199.53 | Professional | None | $125.89 | $154.88 | $199.53 |
CareFirst Setting Professional Modifier None Typical Low $114.82 Median $120.23 Typical High $134.90 | Professional | None | $114.82 | $120.23 | $134.90 |
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 $114.82 Median $147.91 Typical High $199.53 | Professional | None | $114.82 | $147.91 | $199.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $158.49 Median $199.53 Typical High $257.04 | Professional | None | $158.49 | $199.53 | $257.04 |
Medcost Setting Professional Modifier None Typical Low $131.83 Median $177.83 Typical High $204.17 | Professional | None | $131.83 | $177.83 | $204.17 |
Medcost Setting Facility Modifier None Typical Low $128.82 Median $173.78 Typical High $269.15 | Facility | None | $128.82 | $173.78 | $269.15 |
Medcost Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $173.78 | Professional | None | $100.00 | $100.00 | $173.78 |
Sentara Setting Facility Modifier None Typical Low $104.71 Median $154.88 Typical High $758.58 | Facility | None | $104.71 | $154.88 | $758.58 |
Sentara Setting Professional Modifier None Typical Low $144.54 Median $173.78 Typical High $229.09 | Professional | None | $144.54 | $173.78 | $229.09 |
United Setting Professional Modifier None Typical Low $93.33 Median $131.83 Typical High $208.93 | Professional | None | $93.33 | $131.83 | $208.93 |
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 $63.10 Median $66.07 Typical High $83.18 | Professional | 52 · Reduced service | $63.10 | $66.07 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $19.95 Typical High $24.55 | Professional | 55 · Aftercare only | $19.05 | $19.95 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $13.18 Typical High $16.60 | Professional | 56 · Pre-op care only | $12.88 | $13.18 | $16.60 |
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· 29th of 51
$148
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.