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 $83.18 Median $83.18 Typical High $93.33 | Facility | None | $83.18 | $83.18 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $93.33 Typical High $93.33 | Professional | None | $83.18 | $93.33 | $93.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $72.44 Median $85.11 Typical High $95.50 | Professional | None | $72.44 | $85.11 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $57.54 Median $75.86 Typical High $107.15 | Professional | None | $57.54 | $75.86 | $107.15 |
Medcost Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $151.36 | Facility | None | $112.20 | $112.20 | $151.36 |
Sentara Setting Facility Modifier None Typical Low $75.86 Median $85.11 Typical High $426.58 | Facility | None | $75.86 | $85.11 | $426.58 |
Sentara Setting Professional Modifier None Typical Low $83.18 Median $85.11 Typical High $190.55 | Professional | None | $83.18 | $85.11 | $190.55 |
United Setting Professional Modifier None Typical Low $64.57 Median $102.33 Typical High $154.88 | Professional | None | $64.57 | $102.33 | $154.88 |
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 $40.74 Median $45.71 Typical High $45.71 | Professional | 52 · Reduced service | $40.74 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $18.62 Typical High $18.62 | Professional | 53 · Discontinued | $16.60 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $13.80 Typical High $13.80 | Professional | 55 · Aftercare only | $12.30 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $9.33 Typical High $9.33 | Professional | 56 · Pre-op care only | $8.32 | $9.33 | $9.33 |
Where Virginia sits
The same service costs 2.2 times more in Alaska than in Kentucky. 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· 21st 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.