How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $77.62 Median $77.62 Typical High $85.11 | Facility | None | $77.62 | $77.62 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $77.62 Typical High $85.11 | Professional | None | $54.95 | $77.62 | $85.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $85.11 Median $93.33 Typical High $120.23 | Professional | None | $85.11 | $93.33 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $147.91 Typical High $208.93 | Facility | None | $87.10 | $147.91 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $97.72 Median $125.89 Typical High $141.25 | Professional | None | $97.72 | $125.89 | $141.25 |
Medcost Setting Facility Modifier None Typical Low $117.49 Median $151.36 Typical High $151.36 | Facility | None | $117.49 | $151.36 | $151.36 |
Medcost Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
United Setting Professional Modifier None Typical Low $23.99 Median $63.10 Typical High $144.54 | Professional | None | $23.99 | $63.10 | $144.54 |
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 $27.54 Median $38.90 Typical High $42.66 | Professional | 52 · Reduced service | $27.54 | $38.90 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $15.49 Typical High $16.98 | Professional | 53 · Discontinued | $10.96 | $15.49 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $11.75 Typical High $12.88 | Professional | 55 · Aftercare only | $8.32 | $11.75 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $7.76 Typical High $8.51 | Professional | 56 · Pre-op care only | $5.50 | $7.76 | $8.51 |
Where Virginia sits
The same service costs 5.0 times more in Ohio than in Hawaii. 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· 15th of 51
$85.11
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.