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 $173.78 Median $173.78 Typical High $199.53 | Facility | None | $173.78 | $173.78 | $199.53 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $194.98 Typical High $199.53 | Professional | None | $162.18 | $194.98 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $204.17 Typical High $229.09 | Professional | None | $154.88 | $204.17 | $229.09 |
Medcost Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Sentara Setting Facility Modifier None Typical Low $194.98 Median $204.17 Typical High $10,232.93 | Facility | None | $194.98 | $204.17 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $194.98 Median $204.17 Typical High $10,232.93 | Professional | None | $194.98 | $204.17 | $10,232.93 |
United Setting Professional Modifier None Typical Low $158.49 Median $295.12 Typical High $389.05 | Professional | None | $158.49 | $295.12 | $389.05 |
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 $81.28 Median $97.72 Typical High $100.00 | Professional | 52 · Reduced service | $81.28 | $97.72 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $39.81 Typical High $39.81 | Professional | 53 · Discontinued | $32.36 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $29.51 Typical High $30.20 | Professional | 55 · Aftercare only | $24.55 | $29.51 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $19.50 Typical High $19.95 | Professional | 56 · Pre-op care only | $16.22 | $19.50 | $19.95 |
Where Virginia sits
The same service costs 4.7 times more in Alaska than in Alabama. 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
$204
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.