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 $151.36 Median $177.83 Typical High $239.88 | Facility | None | $151.36 | $177.83 | $239.88 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $177.83 Typical High $239.88 | Professional | None | $151.36 | $177.83 | $239.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $131.83 Median $165.96 Typical High $338.84 | Professional | None | $131.83 | $165.96 | $338.84 |
CareFirst Setting Professional Modifier None Typical Low $109.65 Median $114.82 Typical High $144.54 | Professional | None | $109.65 | $114.82 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $190.55 Typical High $295.12 | Professional | None | $151.36 | $190.55 | $295.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $186.21 Median $229.09 Typical High $302.00 | Professional | None | $186.21 | $229.09 | $302.00 |
Medcost Setting Professional Modifier None Typical Low $213.80 Median $269.15 Typical High $309.03 | Professional | None | $213.80 | $269.15 | $309.03 |
Medcost Setting Facility Modifier None Typical Low $199.53 Median $275.42 Typical High $407.38 | Facility | None | $199.53 | $275.42 | $407.38 |
Medcost Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $257.04 | Professional | None | $141.25 | $141.25 | $257.04 |
Sentara Setting Facility Modifier None Typical Low $165.96 Median $245.47 Typical High $7,413.10 | Facility | None | $165.96 | $245.47 | $7,413.10 |
Sentara Setting Professional Modifier None Typical Low $208.93 Median $229.09 Typical High $323.59 | Professional | None | $208.93 | $229.09 | $323.59 |
United Setting Professional Modifier None Typical Low $147.91 Median $194.98 Typical High $309.03 | Professional | None | $147.91 | $194.98 | $309.03 |
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 $89.13 Median $100.00 Typical High $120.23 | Professional | 52 · Reduced service | $89.13 | $100.00 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $30.20 Typical High $35.48 | Professional | 55 · Aftercare only | $26.92 | $30.20 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $19.95 Typical High $23.99 | Professional | 56 · Pre-op care only | $17.78 | $19.95 | $23.99 |
Where Virginia sits
The same service costs 2.4 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· 43rd of 51
$178
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.