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 $112.20 Median $120.23 Typical High $120.23 | Facility | None | $112.20 | $120.23 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $120.23 Typical High $120.23 | Professional | None | $104.71 | $120.23 | $120.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $97.72 Median $123.03 Typical High $134.90 | Professional | None | $97.72 | $123.03 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $91.20 Median $104.71 Typical High $128.82 | Professional | None | $91.20 | $104.71 | $128.82 |
Medcost Setting Facility Modifier None Typical Low $43.65 Median $74.13 Typical High $117.49 | Facility | None | $43.65 | $74.13 | $117.49 |
Medcost Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Sentara Setting Facility Modifier None Typical Low $75.86 Median $109.65 Typical High $288.40 | Facility | None | $75.86 | $109.65 | $288.40 |
Sentara Setting Professional Modifier None Typical Low $52.48 Median $87.10 Typical High $120.23 | Professional | None | $52.48 | $87.10 | $120.23 |
United Setting Professional Modifier None Typical Low $69.18 Median $104.71 Typical High $173.78 | Professional | None | $69.18 | $104.71 | $173.78 |
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 $56.23 Median $60.26 Typical High $60.26 | Professional | 52 · Reduced service | $56.23 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $23.99 Typical High $23.99 | Professional | 53 · Discontinued | $22.39 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $17.78 Typical High $17.78 | Professional | 55 · Aftercare only | $16.60 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $12.02 Typical High $12.02 | Professional | 56 · Pre-op care only | $11.22 | $12.02 | $12.02 |
Where Virginia sits
The same service costs 3.0 times more in Alaska than in West Virginia. 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· 26th of 51
$112
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.