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 $40.74 Median $40.74 Typical High $53.70 | Facility | None | $40.74 | $40.74 | $53.70 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $51.29 Typical High $53.70 | Professional | None | $40.74 | $51.29 | $53.70 |
Anthem BCBS Setting Professional Modifier None Typical Low $21.38 Median $38.90 Typical High $89.13 | Professional | None | $21.38 | $38.90 | $89.13 |
CareFirst Setting Professional Modifier None Typical Low $39.81 Median $42.66 Typical High $52.48 | Professional | None | $39.81 | $42.66 | $52.48 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $35.48 Typical High $91.20 | Professional | None | $30.90 | $35.48 | $91.20 |
Kaiser Permanente Setting Professional Modifier None Typical Low $33.88 Median $46.77 Typical High $93.33 | Professional | None | $33.88 | $46.77 | $93.33 |
Medcost Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $63.10 | Professional | None | $50.12 | $50.12 | $63.10 |
Medcost Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $97.72 | Facility | None | $74.13 | $74.13 | $97.72 |
Medcost Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $56.23 | Professional | None | $37.15 | $37.15 | $56.23 |
Sentara Setting Facility Modifier None Typical Low $33.11 Median $72.44 Typical High $10,232.93 | Facility | None | $33.11 | $72.44 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $42.66 Median $64.57 Typical High $120.23 | Professional | None | $42.66 | $64.57 | $120.23 |
United Setting Professional Modifier None Typical Low $38.90 Median $53.70 Typical High $100.00 | Professional | None | $38.90 | $53.70 | $100.00 |
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 $20.42 Median $25.12 Typical High $26.92 | Professional | 52 · Reduced service | $20.42 | $25.12 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $7.59 Typical High $7.94 | Professional | 55 · Aftercare only | $6.17 | $7.59 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $5.13 Typical High $5.37 | Professional | 56 · Pre-op care only | $4.07 | $5.13 | $5.37 |
Where Virginia sits
The same service costs 2.6 times more in Nebraska than in Texas. 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· 35th of 51
$48.98
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.