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 $38.90 Median $47.86 Typical High $77.62 | Facility | None | $38.90 | $47.86 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $42.66 Typical High $47.86 | Professional | None | $38.90 | $42.66 | $47.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.12 Median $31.62 Typical High $38.90 | Professional | None | $25.12 | $31.62 | $38.90 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | None | $29.51 | $29.51 | $29.51 |
Kaiser Permanente Setting Professional Modifier None Typical Low $28.18 Median $35.48 Typical High $46.77 | Professional | None | $28.18 | $35.48 | $46.77 |
Medcost Setting Professional Modifier None Typical Low $18.20 Median $30.90 Typical High $30.90 | Professional | None | $18.20 | $30.90 | $30.90 |
Medcost Setting Facility Modifier None Typical Low $21.88 Median $34.67 Typical High $52.48 | Facility | None | $21.88 | $34.67 | $52.48 |
Medcost Setting Professional Modifier None Typical Low $19.95 Median $23.99 Typical High $30.20 | Professional | None | $19.95 | $23.99 | $30.20 |
Sentara Setting Facility Modifier None Typical Low $17.38 Median $30.90 Typical High $162.18 | Facility | None | $17.38 | $30.90 | $162.18 |
Sentara Setting Professional Modifier None Typical Low $16.22 Median $22.39 Typical High $41.69 | Professional | None | $16.22 | $22.39 | $41.69 |
United Setting Facility Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Facility | None | $23.99 | $23.99 | $23.99 |
United Setting Professional Modifier None Typical Low $19.05 Median $26.30 Typical High $42.66 | Professional | None | $19.05 | $26.30 | $42.66 |
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 $19.50 Median $21.38 Typical High $23.99 | Professional | 52 · Reduced service | $19.50 | $21.38 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $8.51 Typical High $9.55 | Professional | 53 · Discontinued | $7.76 | $8.51 | $9.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $6.46 Typical High $7.08 | Professional | 55 · Aftercare only | $5.89 | $6.46 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $4.27 Typical High $4.79 | Professional | 56 · Pre-op care only | $3.89 | $4.27 | $4.79 |
Where Virginia sits
The same service costs 3.8 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· 31st of 51
$31.62
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.