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 $20.89 Median $4,365.16 Typical High $14,125.38 | Facility | None | $20.89 | $4,365.16 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $19.05 Median $50.12 Typical High $81.28 | Professional | None | $19.05 | $50.12 | $81.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $20.42 Median $54.95 Typical High $102.33 | Professional | None | $20.42 | $54.95 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $69.18 Median $93.33 Typical High $117.49 | Professional | None | $69.18 | $93.33 | $117.49 |
Medcost Setting Professional Modifier None Typical Low $43.65 Median $63.10 Typical High $63.10 | Professional | None | $43.65 | $63.10 | $63.10 |
Medcost Setting Facility Modifier None Typical Low $18.62 Median $53.70 Typical High $79.43 | Facility | None | $18.62 | $53.70 | $79.43 |
Medcost Setting Professional Modifier None Typical Low $16.60 Median $33.11 Typical High $56.23 | Professional | None | $16.60 | $33.11 | $56.23 |
Sentara Setting Facility Modifier None Typical Low $21.38 Median $28.84 Typical High $398.11 | Facility | None | $21.38 | $28.84 | $398.11 |
Sentara Setting Professional Modifier None Typical Low $37.15 Median $70.79 Typical High $102.33 | Professional | None | $37.15 | $70.79 | $102.33 |
United Setting Facility Modifier None Typical Low $380.19 Median $416.87 Typical High $933.25 | Facility | None | $380.19 | $416.87 | $933.25 |
United Setting Professional Modifier None Typical Low $19.05 Median $36.31 Typical High $81.28 | Professional | None | $19.05 | $36.31 | $81.28 |
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 $9.55 Median $20.89 Typical High $40.74 | Professional | 52 · Reduced service | $9.55 | $20.89 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.80 Median $8.51 Typical High $16.22 | Professional | 53 · Discontinued | $3.80 | $8.51 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.88 Median $6.31 Typical High $12.30 | Professional | 55 · Aftercare only | $2.88 | $6.31 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.91 Median $4.27 Typical High $8.13 | Professional | 56 · Pre-op care only | $1.91 | $4.27 | $8.13 |
Where Virginia sits
The same service costs 6.5 times more in Alaska than in Indiana. 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· 29th of 51
$63.10
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.