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 $213.80 Median $213.80 Typical High $234.42 | Facility | None | $213.80 | $213.80 | $234.42 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $234.42 | Professional | None | $213.80 | $213.80 | $234.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $79.43 Median $208.93 Typical High $208.93 | Professional | None | $79.43 | $208.93 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
Kaiser Permanente Setting Professional Modifier None Typical Low $194.98 Median $218.78 Typical High $257.04 | Professional | None | $194.98 | $218.78 | $257.04 |
Medcost Setting Facility Modifier None Typical Low $128.82 Median $213.80 Typical High $245.47 | Facility | None | $128.82 | $213.80 | $245.47 |
Medcost Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
Sentara Setting Facility Modifier None Typical Low $144.54 Median $208.93 Typical High $758.58 | Facility | None | $144.54 | $208.93 | $758.58 |
Sentara Setting Professional Modifier None Typical Low $104.71 Median $173.78 Typical High $223.87 | Professional | None | $104.71 | $173.78 | $223.87 |
United Setting Professional Modifier None Typical Low $138.04 Median $223.87 Typical High $363.08 | Professional | None | $138.04 | $223.87 | $363.08 |
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 $107.15 Median $107.15 Typical High $114.82 | Professional | 52 · Reduced service | $107.15 | $107.15 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $42.66 Typical High $46.77 | Professional | 53 · Discontinued | $42.66 | $42.66 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $32.36 Typical High $34.67 | Professional | 55 · Aftercare only | $32.36 | $32.36 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $21.38 Typical High $23.44 | Professional | 56 · Pre-op care only | $21.38 | $21.38 | $23.44 |
Where Virginia sits
The same service costs 6.6 times more in Alabama than in New York. 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· 31st of 51
$209
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.