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 $112.20 Median $144.54 Typical High $181.97 | Facility | None | $112.20 | $144.54 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $144.54 Typical High $186.21 | Professional | None | $112.20 | $144.54 | $186.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $104.71 Median $125.89 Typical High $275.42 | Professional | None | $104.71 | $125.89 | $275.42 |
CareFirst Setting Professional Modifier None Typical Low $83.18 Median $87.10 Typical High $107.15 | Professional | None | $83.18 | $87.10 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $144.54 Typical High $234.42 | Professional | None | $114.82 | $144.54 | $234.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $141.25 Median $177.83 Typical High $234.42 | Professional | None | $141.25 | $177.83 | $234.42 |
Medcost Setting Professional Modifier None Typical Low $165.96 Median $208.93 Typical High $239.88 | Professional | None | $165.96 | $208.93 | $239.88 |
Medcost Setting Facility Modifier None Typical Low $151.36 Median $223.87 Typical High $331.13 | Facility | None | $151.36 | $223.87 | $331.13 |
Medcost Setting Professional Modifier None Typical Low $125.89 Median $128.82 Typical High $199.53 | Professional | None | $125.89 | $128.82 | $199.53 |
Sentara Setting Facility Modifier None Typical Low $128.82 Median $194.98 Typical High $7,413.10 | Facility | None | $128.82 | $194.98 | $7,413.10 |
Sentara Setting Professional Modifier None Typical Low $162.18 Median $181.97 Typical High $269.15 | Professional | None | $162.18 | $181.97 | $269.15 |
United Setting Professional Modifier None Typical Low $117.49 Median $154.88 Typical High $245.47 | Professional | None | $117.49 | $154.88 | $245.47 |
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 $72.44 Median $75.86 Typical High $91.20 | Professional | 52 · Reduced service | $72.44 | $75.86 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $22.39 Typical High $27.54 | Professional | 55 · Aftercare only | $21.88 | $22.39 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $15.14 Typical High $18.20 | Professional | 56 · Pre-op care only | $14.45 | $15.14 | $18.20 |
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· 42nd of 51
$145
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.