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 $151.36 Median $151.36 Typical High $190.55 | Facility | None | $151.36 | $151.36 | $190.55 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $151.36 Typical High $190.55 | Professional | None | $120.23 | $151.36 | $190.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.96 Median $12.88 Typical High $15.85 | Professional | None | $10.96 | $12.88 | $15.85 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Kaiser Permanente Setting Professional Modifier None Typical Low $186.21 Median $257.04 Typical High $275.42 | Professional | None | $186.21 | $257.04 | $275.42 |
Medcost Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $251.19 | Facility | None | $186.21 | $186.21 | $251.19 |
Sentara Setting Facility Modifier None Typical Low $123.03 Median $190.55 Typical High $10,232.93 | Facility | None | $123.03 | $190.55 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $123.03 Median $190.55 Typical High $10,232.93 | Professional | None | $123.03 | $190.55 | $10,232.93 |
United Setting Professional Modifier None Typical Low $120.23 Median $194.98 Typical High $251.19 | Professional | None | $120.23 | $194.98 | $251.19 |
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 $60.26 Median $75.86 Typical High $95.50 | Professional | 52 · Reduced service | $60.26 | $75.86 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $30.20 Typical High $38.02 | Professional | 53 · Discontinued | $24.55 | $30.20 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $22.91 Typical High $28.84 | Professional | 55 · Aftercare only | $18.20 | $22.91 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $15.14 Typical High $19.05 | Professional | 56 · Pre-op care only | $12.02 | $15.14 | $19.05 |
Where Virginia sits
The same service costs 20.0 times more in Alaska than in Virginia. 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· 51st of 51
$35.48
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.