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 $213.80 Median $275.42 Typical High $363.08 | Facility | None | $213.80 | $275.42 | $363.08 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $281.84 Typical High $389.05 | Professional | None | $213.80 | $281.84 | $389.05 |
Anthem BCBS Setting Professional Modifier None Typical Low $467.74 Median $549.54 Typical High $616.60 | Professional | None | $467.74 | $549.54 | $616.60 |
CareFirst Setting Professional Modifier None Typical Low $309.03 Median $346.74 Typical High $398.11 | Professional | None | $309.03 | $346.74 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $436.52 Median $537.03 Typical High $707.95 | Professional | None | $436.52 | $537.03 | $707.95 |
Medcost Setting Professional Modifier None Typical Low $263.03 Median $346.74 Typical High $398.11 | Professional | None | $263.03 | $346.74 | $398.11 |
Sentara Setting Facility Modifier None Typical Low $208.93 Median $371.54 Typical High $2,041.74 | Facility | None | $208.93 | $371.54 | $2,041.74 |
Sentara Setting Professional Modifier None Typical Low $245.47 Median $407.38 Typical High $588.84 | Professional | None | $245.47 | $407.38 | $588.84 |
United Setting Facility Modifier None Typical Low $338.84 Median $371.54 Typical High $831.76 | Facility | None | $338.84 | $371.54 | $831.76 |
United Setting Professional Modifier None Typical Low $239.88 Median $346.74 Typical High $575.44 | Professional | None | $239.88 | $346.74 | $575.44 |
5 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 $128.82 Median $181.97 Typical High $190.55 | Professional | 52 · Reduced service | $128.82 | $181.97 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $72.44 Typical High $77.62 | Professional | 53 · Discontinued | $51.29 | $72.44 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $54.95 Typical High $57.54 | Professional | 55 · Aftercare only | $38.90 | $54.95 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $36.31 Typical High $38.90 | Professional | 56 · Pre-op care only | $25.70 | $36.31 | $38.90 |
Anthem BCBS Setting Professional Modifier HF · Substance use program Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | HF · Substance use program | $851.14 | $851.14 | $851.14 |
Where Virginia sits
The same service costs 2.1 times more in Wyoming than in Maryland. 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
$363
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.