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 $83.18 Median $114.82 Typical High $165.96 | Facility | None | $83.18 | $114.82 | $165.96 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $107.15 Typical High $144.54 | Professional | None | $79.43 | $107.15 | $144.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $81.28 Median $107.15 Typical High $138.04 | Professional | None | $81.28 | $107.15 | $138.04 |
CareFirst Setting Professional Modifier None Typical Low $69.18 Median $72.44 Typical High $83.18 | Professional | None | $69.18 | $72.44 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $102.33 Typical High $138.04 | Professional | None | $72.44 | $102.33 | $138.04 |
Kaiser Permanente Setting Professional Modifier None Typical Low $109.65 Median $134.90 Typical High $177.83 | Professional | None | $109.65 | $134.90 | $177.83 |
Medcost Setting Professional Modifier None Typical Low $91.20 Median $114.82 Typical High $134.90 | Professional | None | $91.20 | $114.82 | $134.90 |
Medcost Setting Facility Modifier None Typical Low $83.18 Median $120.23 Typical High $194.98 | Facility | None | $83.18 | $120.23 | $194.98 |
Medcost Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $102.33 | Professional | None | $54.95 | $54.95 | $102.33 |
Sentara Setting Facility Modifier None Typical Low $70.79 Median $104.71 Typical High $602.56 | Facility | None | $70.79 | $104.71 | $602.56 |
Sentara Setting Professional Modifier None Typical Low $93.33 Median $120.23 Typical High $162.18 | Professional | None | $93.33 | $120.23 | $162.18 |
United Setting Professional Modifier None Typical Low $61.66 Median $91.20 Typical High $147.91 | Professional | None | $61.66 | $91.20 | $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 $39.81 Median $44.67 Typical High $57.54 | Professional | 52 · Reduced service | $39.81 | $44.67 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $13.49 Typical High $17.38 | Professional | 55 · Aftercare only | $12.02 | $13.49 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $9.12 Typical High $11.48 | Professional | 56 · Pre-op care only | $7.94 | $9.12 | $11.48 |
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· 35th of 51
$102
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.