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 $41.69 Median $47.86 Typical High $74.13 | Facility | None | $41.69 | $47.86 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $47.86 Typical High $74.13 | Professional | None | $41.69 | $47.86 | $74.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $37.15 Median $53.70 Typical High $79.43 | Professional | None | $37.15 | $53.70 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $56.23 Median $74.13 Typical High $95.50 | Professional | None | $56.23 | $74.13 | $95.50 |
Medcost Setting Professional Modifier None Typical Low $72.44 Median $91.20 Typical High $91.20 | Professional | None | $72.44 | $91.20 | $91.20 |
Medcost Setting Facility Modifier None Typical Low $33.88 Median $64.57 Typical High $120.23 | Facility | None | $33.88 | $64.57 | $120.23 |
Medcost Setting Professional Modifier None Typical Low $30.20 Median $42.66 Typical High $61.66 | Professional | None | $30.20 | $42.66 | $61.66 |
Sentara Setting Facility Modifier None Typical Low $38.90 Median $52.48 Typical High $331.13 | Facility | None | $38.90 | $52.48 | $331.13 |
Sentara Setting Professional Modifier None Typical Low $58.88 Median $67.61 Typical High $89.13 | Professional | None | $58.88 | $67.61 | $89.13 |
United Setting Facility Modifier None Typical Low $251.19 Median $275.42 Typical High $616.60 | Facility | None | $251.19 | $275.42 | $616.60 |
United Setting Professional Modifier None Typical Low $34.67 Median $53.70 Typical High $85.11 | Professional | None | $34.67 | $53.70 | $85.11 |
3 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 $20.42 Median $23.99 Typical High $37.15 | Professional | 52 · Reduced service | $20.42 | $23.99 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $7.24 Typical High $10.96 | Professional | 55 · Aftercare only | $6.17 | $7.24 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.79 Typical High $7.41 | Professional | 56 · Pre-op care only | $4.17 | $4.79 | $7.41 |
Where Virginia sits
The same service costs 2.3 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· 32nd of 51
$58.88
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.