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 $87.10 Median $91.20 Typical High $128.82 | Facility | None | $87.10 | $91.20 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $117.49 Typical High $158.49 | Professional | None | $87.10 | $117.49 | $158.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $89.13 Median $120.23 Typical High $154.88 | Professional | None | $89.13 | $120.23 | $154.88 |
CareFirst Setting Professional Modifier None Typical Low $75.86 Median $79.43 Typical High $89.13 | Professional | None | $75.86 | $79.43 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $114.82 Typical High $154.88 | Professional | None | $79.43 | $114.82 | $154.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $120.23 Median $151.36 Typical High $194.98 | Professional | None | $120.23 | $151.36 | $194.98 |
Medcost Setting Professional Modifier None Typical Low $112.20 Median $138.04 Typical High $165.96 | Professional | None | $112.20 | $138.04 | $165.96 |
Medcost Setting Facility Modifier None Typical Low $91.20 Median $138.04 Typical High $239.88 | Facility | None | $91.20 | $138.04 | $239.88 |
Medcost Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $117.49 | Professional | None | $75.86 | $75.86 | $117.49 |
Sentara Setting Facility Modifier None Typical Low $79.43 Median $117.49 Typical High $660.69 | Facility | None | $79.43 | $117.49 | $660.69 |
Sentara Setting Professional Modifier None Typical Low $114.82 Median $134.90 Typical High $177.83 | Professional | None | $114.82 | $134.90 | $177.83 |
United Setting Professional Modifier None Typical Low $69.18 Median $107.15 Typical High $165.96 | Professional | None | $69.18 | $107.15 | $165.96 |
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 $43.65 Median $48.98 Typical High $64.57 | Professional | 52 · Reduced service | $43.65 | $48.98 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $14.79 Typical High $19.50 | Professional | 55 · Aftercare only | $13.18 | $14.79 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $9.77 Typical High $12.88 | Professional | 56 · Pre-op care only | $8.71 | $9.77 | $12.88 |
Where Virginia sits
The same service costs 2.7 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· 36th of 51
$115
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.