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 $74.13 Median $75.86 Typical High $114.82 | Facility | None | $74.13 | $75.86 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $104.71 Typical High $131.83 | Professional | None | $74.13 | $104.71 | $131.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $74.13 Median $102.33 Typical High $134.90 | Professional | None | $74.13 | $102.33 | $134.90 |
CareFirst Setting Professional Modifier None Typical Low $63.10 Median $66.07 Typical High $75.86 | Professional | None | $63.10 | $66.07 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $100.00 Typical High $138.04 | Professional | None | $66.07 | $100.00 | $138.04 |
Kaiser Permanente Setting Professional Modifier None Typical Low $102.33 Median $131.83 Typical High $173.78 | Professional | None | $102.33 | $131.83 | $173.78 |
Medcost Setting Professional Modifier None Typical Low $104.71 Median $128.82 Typical High $154.88 | Professional | None | $104.71 | $128.82 | $154.88 |
Medcost Setting Facility Modifier None Typical Low $75.86 Median $123.03 Typical High $208.93 | Facility | None | $75.86 | $123.03 | $208.93 |
Medcost Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $107.15 | Professional | None | $60.26 | $60.26 | $107.15 |
Sentara Setting Facility Modifier None Typical Low $70.79 Median $102.33 Typical High $575.44 | Facility | None | $70.79 | $102.33 | $575.44 |
Sentara Setting Professional Modifier None Typical Low $107.15 Median $123.03 Typical High $165.96 | Professional | None | $107.15 | $123.03 | $165.96 |
United Setting Professional Modifier None Typical Low $61.66 Median $89.13 Typical High $147.91 | Professional | None | $61.66 | $89.13 | $147.91 |
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 $36.31 Median $42.66 Typical High $57.54 | Professional | 52 · Reduced service | $36.31 | $42.66 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $12.88 Typical High $16.98 | Professional | 55 · Aftercare only | $10.96 | $12.88 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $8.51 Typical High $11.48 | Professional | 56 · Pre-op care only | $7.41 | $8.51 | $11.48 |
Where Virginia sits
The same service costs 2.8 times more in Alaska than in Washington, DC. 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· 37th of 51
$100
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.