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 $234.42 Median $234.42 Typical High $245.47 | Facility | None | $234.42 | $234.42 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $239.88 Typical High $257.04 | Professional | None | $234.42 | $239.88 | $257.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $229.09 Median $467.74 Typical High $758.58 | Facility | None | $229.09 | $467.74 | $758.58 |
Anthem BCBS Setting Professional Modifier None Typical Low $199.53 Median $234.42 Typical High $234.42 | Professional | None | $199.53 | $234.42 | $234.42 |
CareFirst Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $229.09 | Professional | None | $218.78 | $218.78 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $436.52 Typical High $602.56 | Facility | None | $338.84 | $436.52 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $199.53 Median $245.47 Typical High $281.84 | Professional | None | $199.53 | $245.47 | $281.84 |
Medcost Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
Medcost Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $331.13 | Facility | None | $239.88 | $239.88 | $331.13 |
Sentara Setting Facility Modifier None Typical Low $223.87 Median $234.42 Typical High $302.00 | Facility | None | $223.87 | $234.42 | $302.00 |
Sentara Setting Professional Modifier None Typical Low $223.87 Median $234.42 Typical High $302.00 | Professional | None | $223.87 | $234.42 | $302.00 |
United Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
United Setting Professional Modifier None Typical Low $218.78 Median $229.09 Typical High $239.88 | Professional | None | $218.78 | $229.09 | $239.88 |
2 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 55 · Aftercare only Typical Low $34.67 Median $35.48 Typical High $36.31 | Professional | 55 · Aftercare only | $34.67 | $35.48 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.44 Typical High $24.55 | Professional | 56 · Pre-op care only | $23.44 | $23.44 | $24.55 |
Where Virginia sits
The same service costs 1.6 times more in Arizona than in Hawaii. 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· 26th of 51
$234
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.