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 $22.39 Median $23.44 Typical High $25.12 | Facility | None | $22.39 | $23.44 | $25.12 |
Aetna Setting Professional Modifier None Typical Low $22.39 Median $23.44 Typical High $25.12 | Professional | None | $22.39 | $23.44 | $25.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $14.13 Median $17.78 Typical High $21.38 | Professional | None | $14.13 | $17.78 | $21.38 |
Cigna Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | None | $15.85 | $15.85 | $15.85 |
Kaiser Permanente Setting Professional Modifier None Typical Low $15.14 Median $19.05 Typical High $25.12 | Professional | None | $15.14 | $19.05 | $25.12 |
Medcost Setting Professional Modifier None Typical Low $7.41 Median $15.49 Typical High $15.49 | Professional | None | $7.41 | $15.49 | $15.49 |
Medcost Setting Facility Modifier None Typical Low $11.75 Median $16.98 Typical High $28.84 | Facility | None | $11.75 | $16.98 | $28.84 |
Medcost Setting Professional Modifier None Typical Low $10.72 Median $12.30 Typical High $14.45 | Professional | None | $10.72 | $12.30 | $14.45 |
Sentara Setting Facility Modifier None Typical Low $8.51 Median $16.98 Typical High $85.11 | Facility | None | $8.51 | $16.98 | $85.11 |
Sentara Setting Professional Modifier None Typical Low $6.46 Median $12.59 Typical High $21.38 | Professional | None | $6.46 | $12.59 | $21.38 |
United Setting Facility Modifier None Typical Low $13.49 Median $13.49 Typical High $13.49 | Facility | None | $13.49 | $13.49 | $13.49 |
United Setting Professional Modifier None Typical Low $10.00 Median $14.13 Typical High $23.44 | Professional | None | $10.00 | $14.13 | $23.44 |
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 $11.22 Median $11.75 Typical High $12.59 | Professional | 52 · Reduced service | $11.22 | $11.75 | $12.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.47 Median $4.68 Typical High $5.01 | Professional | 53 · Discontinued | $4.47 | $4.68 | $5.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.31 Median $3.55 Typical High $3.80 | Professional | 55 · Aftercare only | $3.31 | $3.55 | $3.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.24 Median $2.34 Typical High $2.51 | Professional | 56 · Pre-op care only | $2.24 | $2.34 | $2.51 |
Where Virginia sits
The same service costs 3.2 times more in Alaska than in New York. 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· 30th of 51
$16.98
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.