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 $50.12 Median $50.12 Typical High $61.66 | Facility | None | $50.12 | $50.12 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $61.66 Typical High $61.66 | Professional | None | $50.12 | $61.66 | $61.66 |
Anthem BCBS Setting Professional Modifier None Typical Low $45.71 Median $52.48 Typical High $58.88 | Professional | None | $45.71 | $52.48 | $58.88 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $35.48 Median $45.71 Typical High $64.57 | Professional | None | $35.48 | $45.71 | $64.57 |
Medcost Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $100.00 | Facility | None | $74.13 | $74.13 | $100.00 |
Sentara Setting Facility Modifier None Typical Low $48.98 Median $56.23 Typical High $281.84 | Facility | None | $48.98 | $56.23 | $281.84 |
Sentara Setting Professional Modifier None Typical Low $53.70 Median $56.23 Typical High $125.89 | Professional | None | $53.70 | $56.23 | $125.89 |
United Setting Professional Modifier None Typical Low $42.66 Median $67.61 Typical High $100.00 | Professional | None | $42.66 | $67.61 | $100.00 |
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 $25.12 Median $30.20 Typical High $30.20 | Professional | 52 · Reduced service | $25.12 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $12.30 Typical High $12.30 | Professional | 53 · Discontinued | $10.00 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $9.12 Typical High $9.12 | Professional | 55 · Aftercare only | $7.59 | $9.12 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $6.17 Typical High $6.17 | Professional | 56 · Pre-op care only | $5.01 | $6.17 | $6.17 |
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· 27th of 51
$52.48
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.