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 $346.74 Median $346.74 Typical High $380.19 | Facility | None | $346.74 | $346.74 | $380.19 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $380.19 | Professional | None | $346.74 | $346.74 | $380.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $316.23 | Professional | None | $275.42 | $275.42 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $426.58 Median $512.86 Typical High $776.25 | Professional | None | $426.58 | $512.86 | $776.25 |
Medcost Setting Facility Modifier None Typical Low $537.03 Median $676.08 Typical High $676.08 | Facility | None | $537.03 | $676.08 | $676.08 |
Medcost Setting Professional Modifier None Typical Low $288.40 Median $436.52 Typical High $478.63 | Professional | None | $288.40 | $436.52 | $478.63 |
Sentara Setting Facility Modifier None Typical Low $389.05 Median $724.44 Typical High $10,232.93 | Facility | None | $389.05 | $724.44 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $416.87 Median $467.74 Typical High $724.44 | Professional | None | $416.87 | $467.74 | $724.44 |
United Setting Professional Modifier None Typical Low $269.15 Median $346.74 Typical High $660.69 | Professional | None | $269.15 | $346.74 | $660.69 |
4 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 $173.78 Median $173.78 Typical High $190.55 | Professional | 52 · Reduced service | $173.78 | $173.78 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $69.18 Typical High $75.86 | Professional | 53 · Discontinued | $69.18 | $69.18 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $57.54 | Professional | 55 · Aftercare only | $52.48 | $52.48 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $34.67 Typical High $38.02 | Professional | 56 · Pre-op care only | $34.67 | $34.67 | $38.02 |
Where Virginia sits
The same service costs 17.0 times more in Iowa than in Kentucky. 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· 19th of 51
$372
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.