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 $117.49 Median $134.90 Typical High $158.49 | Facility | None | $117.49 | $134.90 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $154.88 Typical High $245.47 | Professional | None | $117.49 | $154.88 | $245.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $81.28 Median $151.36 Typical High $398.11 | Professional | None | $81.28 | $151.36 | $398.11 |
CareFirst Setting Professional Modifier None Typical Low $112.20 Median $117.49 Typical High $144.54 | Professional | None | $112.20 | $117.49 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $154.88 Typical High $302.00 | Professional | None | $117.49 | $154.88 | $302.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $134.90 Median $165.96 Typical High $288.40 | Professional | None | $134.90 | $165.96 | $288.40 |
Medcost Setting Professional Modifier None Typical Low $169.82 Median $194.98 Typical High $288.40 | Professional | None | $169.82 | $194.98 | $288.40 |
Medcost Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $302.00 | Facility | None | $239.88 | $239.88 | $302.00 |
Medcost Setting Professional Modifier None Typical Low $131.83 Median $134.90 Typical High $181.97 | Professional | None | $131.83 | $134.90 | $181.97 |
Sentara Setting Facility Modifier None Typical Low $123.03 Median $213.80 Typical High $10,232.93 | Facility | None | $123.03 | $213.80 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $138.04 Median $186.21 Typical High $389.05 | Professional | None | $138.04 | $186.21 | $389.05 |
United Setting Professional Modifier None Typical Low $128.82 Median $173.78 Typical High $323.59 | Professional | None | $128.82 | $173.78 | $323.59 |
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 $69.18 Median $77.62 Typical High $77.62 | Professional | 52 · Reduced service | $69.18 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | 55 · Aftercare only | $23.44 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.85 Typical High $15.85 | Professional | 56 · Pre-op care only | $15.49 | $15.85 | $15.85 |
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· 33rd of 51
$155
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.