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 $218.78 Median $218.78 Typical High $245.47 | Facility | None | $218.78 | $218.78 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $245.47 Typical High $245.47 | Professional | None | $218.78 | $245.47 | $245.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $194.98 Median $223.87 Typical High $251.19 | Professional | None | $194.98 | $223.87 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $204.17 Typical High $288.40 | Professional | None | $154.88 | $204.17 | $288.40 |
Medcost Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $398.11 | Facility | None | $295.12 | $295.12 | $398.11 |
Sentara Setting Facility Modifier None Typical Low $199.53 Median $223.87 Typical High $1,122.02 | Facility | None | $199.53 | $223.87 | $1,122.02 |
Sentara Setting Professional Modifier None Typical Low $218.78 Median $223.87 Typical High $501.19 | Professional | None | $218.78 | $223.87 | $501.19 |
United Setting Professional Modifier None Typical Low $173.78 Median $275.42 Typical High $407.38 | Professional | None | $173.78 | $275.42 | $407.38 |
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 $109.65 Median $123.03 Typical High $123.03 | Professional | 52 · Reduced service | $109.65 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $48.98 Typical High $48.98 | Professional | 53 · Discontinued | $44.67 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $36.31 Typical High $36.31 | Professional | 55 · Aftercare only | $33.11 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $24.55 Typical High $24.55 | Professional | 56 · Pre-op care only | $21.88 | $24.55 | $24.55 |
Where Virginia sits
The same service costs 2.2 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· 18th of 51
$224
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.