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 $169.82 Median $169.82 Typical High $199.53 | Facility | None | $169.82 | $169.82 | $199.53 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $199.53 Typical High $199.53 | Professional | None | $169.82 | $199.53 | $199.53 |
Anthem BCBS Setting Professional Modifier None Typical Low $147.91 Median $169.82 Typical High $190.55 | Professional | None | $147.91 | $169.82 | $190.55 |
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 $114.82 Median $151.36 Typical High $213.80 | Professional | None | $114.82 | $151.36 | $213.80 |
Medcost Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $331.13 | Facility | None | $245.47 | $245.47 | $331.13 |
Sentara Setting Facility Modifier None Typical Low $162.18 Median $186.21 Typical High $912.01 | Facility | None | $162.18 | $186.21 | $912.01 |
Sentara Setting Professional Modifier None Typical Low $177.83 Median $186.21 Typical High $416.87 | Professional | None | $177.83 | $186.21 | $416.87 |
United Setting Professional Modifier None Typical Low $141.25 Median $223.87 Typical High $331.13 | Professional | None | $141.25 | $223.87 | $331.13 |
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 $85.11 Median $100.00 Typical High $100.00 | Professional | 52 · Reduced service | $85.11 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $39.81 Typical High $39.81 | Professional | 53 · Discontinued | $33.88 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $30.20 Typical High $30.20 | Professional | 55 · Aftercare only | $25.12 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $19.95 Typical High $19.95 | Professional | 56 · Pre-op care only | $16.98 | $19.95 | $19.95 |
Where Virginia sits
The same service costs 2.3 times more in Alaska than in Arizona. 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· 32nd of 51
$170
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.