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 $54.95 Median $61.66 Typical High $77.62 | Facility | None | $54.95 | $61.66 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $69.18 Typical High $107.15 | Professional | None | $54.95 | $69.18 | $107.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $63.10 Median $77.62 Typical High $91.20 | Professional | None | $63.10 | $77.62 | $91.20 |
CareFirst Setting Professional Modifier None Typical Low $66.07 Median $69.18 Typical High $69.18 | Professional | None | $66.07 | $69.18 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $85.11 Typical High $128.82 | Professional | None | $69.18 | $85.11 | $128.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $72.44 Median $114.82 Typical High $125.89 | Professional | None | $72.44 | $114.82 | $125.89 |
Medcost Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
Medcost Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $131.83 | Facility | None | $83.18 | $83.18 | $131.83 |
Sentara Setting Facility Modifier None Typical Low $60.26 Median $74.13 Typical High $363.08 | Facility | None | $60.26 | $74.13 | $363.08 |
Sentara Setting Professional Modifier None Typical Low $60.26 Median $74.13 Typical High $371.54 | Professional | None | $60.26 | $74.13 | $371.54 |
United Setting Professional Modifier None Typical Low $52.48 Median $104.71 Typical High $128.82 | Professional | None | $52.48 | $104.71 | $128.82 |
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 $29.51 Median $36.31 Typical High $38.90 | Professional | 52 · Reduced service | $29.51 | $36.31 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $10.96 Typical High $11.75 | Professional | 55 · Aftercare only | $8.91 | $10.96 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $7.24 Typical High $7.76 | Professional | 56 · Pre-op care only | $5.89 | $7.24 | $7.76 |
Where Virginia sits
The same service costs 2.6 times more in Alaska than in Utah. 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· 28th of 51
$74.13
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.