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 $81.28 Median $81.28 Typical High $85.11 | Facility | None | $81.28 | $81.28 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $85.11 Typical High $85.11 | Professional | None | $81.28 | $85.11 | $85.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $69.18 Median $79.43 Typical High $89.13 | Professional | None | $69.18 | $79.43 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
Kaiser Permanente Setting Professional Modifier None Typical Low $52.48 Median $69.18 Typical High $97.72 | Professional | None | $52.48 | $69.18 | $97.72 |
Medcost Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $138.04 | Facility | None | $104.71 | $104.71 | $138.04 |
Sentara Setting Facility Modifier None Typical Low $66.07 Median $77.62 Typical High $144.54 | Facility | None | $66.07 | $77.62 | $144.54 |
Sentara Setting Professional Modifier None Typical Low $75.86 Median $77.62 Typical High $144.54 | Professional | None | $75.86 | $77.62 | $144.54 |
United Setting Professional Modifier None Typical Low $60.26 Median $95.50 Typical High $144.54 | Professional | None | $60.26 | $95.50 | $144.54 |
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 $39.81 Median $42.66 Typical High $42.66 | Professional | 52 · Reduced service | $39.81 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $16.98 Typical High $16.98 | Professional | 53 · Discontinued | $16.22 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.88 Typical High $12.88 | Professional | 55 · Aftercare only | $12.02 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.51 Typical High $8.51 | Professional | 56 · Pre-op care only | $8.13 | $8.51 | $8.51 |
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· 19th of 51
$81.28
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.