How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $1,000.00 Median $1,000.00 Typical High $1,071.52 | Facility | None | $1,000.00 | $1,000.00 | $1,071.52 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $1,000.00 Typical High $1,071.52 | Professional | None | $812.83 | $1,000.00 | $1,071.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $61.66 Median $72.44 Typical High $79.43 | Professional | None | $61.66 | $72.44 | $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 $588.84 Median $588.84 Typical High $660.69 | Professional | None | $588.84 | $588.84 | $660.69 |
Medcost Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Facility | None | $1,513.56 | $1,513.56 | $1,513.56 |
Sentara Setting Facility Modifier None Typical Low $7,413.10 Median $10,232.93 Typical High $11,481.54 | Facility | None | $7,413.10 | $10,232.93 | $11,481.54 |
Sentara Setting Professional Modifier None Typical Low $6.17 Median $6.76 Typical High $7.59 | Professional | None | $6.17 | $6.76 | $7.59 |
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 $501.19 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $501.19 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $199.53 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $147.91 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $100.00 | $107.15 | $107.15 |
Where Virginia sits
The same service costs 17.8 times more in Idaho than in New Mexico. 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· 41st of 51
$72.44
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.