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 $16.60 Median $23.44 Typical High $30.90 | Facility | None | $16.60 | $23.44 | $30.90 |
Aetna Setting Professional Modifier None Typical Low $16.60 Median $16.98 Typical High $16.98 | Professional | None | $16.60 | $16.98 | $16.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $14.13 Median $16.60 Typical High $20.89 | Professional | None | $14.13 | $16.60 | $20.89 |
Cigna Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | None | $14.79 | $14.79 | $14.79 |
Kaiser Permanente Setting Professional Modifier None Typical Low $15.85 Median $17.78 Typical High $23.44 | Professional | None | $15.85 | $17.78 | $23.44 |
Medcost Setting Professional Modifier None Typical Low $21.38 Median $26.92 Typical High $26.92 | Professional | None | $21.38 | $26.92 | $26.92 |
Medcost Setting Facility Modifier None Typical Low $12.88 Median $18.20 Typical High $40.74 | Facility | None | $12.88 | $18.20 | $40.74 |
Medcost Setting Professional Modifier None Typical Low $10.23 Median $12.30 Typical High $18.20 | Professional | None | $10.23 | $12.30 | $18.20 |
Sentara Setting Facility Modifier None Typical Low $14.45 Median $19.05 Typical High $223.87 | Facility | None | $14.45 | $19.05 | $223.87 |
Sentara Setting Professional Modifier None Typical Low $14.79 Median $16.60 Typical High $23.44 | Professional | None | $14.79 | $16.60 | $23.44 |
United Setting Facility Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Facility | None | $17.78 | $17.78 | $17.78 |
United Setting Professional Modifier None Typical Low $10.47 Median $14.45 Typical High $25.70 | Professional | None | $10.47 | $14.45 | $25.70 |
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 $8.32 Median $8.51 Typical High $8.51 | Professional | 52 · Reduced service | $8.32 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.31 Median $3.39 Typical High $3.39 | Professional | 53 · Discontinued | $3.31 | $3.39 | $3.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.51 Median $2.51 Typical High $2.51 | Professional | 55 · Aftercare only | $2.51 | $2.51 | $2.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.66 Median $1.70 Typical High $1.70 | Professional | 56 · Pre-op care only | $1.66 | $1.70 | $1.70 |
Where Virginia sits
The same service costs 2.8 times more in Alaska than in Louisiana. 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
$16.60
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.