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 $83.18 Median $83.18 Typical High $89.13 | Facility | None | $83.18 | $83.18 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $85.11 Typical High $89.13 | Professional | None | $83.18 | $85.11 | $89.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $81.28 Median $169.82 Typical High $275.42 | Facility | None | $81.28 | $169.82 | $275.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $70.79 Median $83.18 Typical High $83.18 | Professional | None | $70.79 | $83.18 | $83.18 |
CareFirst Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $81.28 | Professional | None | $75.86 | $75.86 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $158.49 Typical High $218.78 | Facility | None | $123.03 | $158.49 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $70.79 Median $89.13 Typical High $100.00 | Professional | None | $70.79 | $89.13 | $100.00 |
Medcost Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $134.90 | Facility | None | $81.28 | $81.28 | $134.90 |
Sentara Setting Facility Modifier None Typical Low $77.62 Median $87.10 Typical High $109.65 | Facility | None | $77.62 | $87.10 | $109.65 |
Sentara Setting Professional Modifier None Typical Low $77.62 Median $87.10 Typical High $109.65 | Professional | None | $77.62 | $87.10 | $109.65 |
United Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
United Setting Professional Modifier None Typical Low $79.43 Median $81.28 Typical High $85.11 | Professional | None | $79.43 | $81.28 | $85.11 |
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 $41.69 Median $42.66 Typical High $43.65 | Professional | 52 · Reduced service | $41.69 | $42.66 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $17.78 | Professional | 53 · Discontinued | $16.98 | $16.98 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $13.18 | Professional | 55 · Aftercare only | $12.59 | $12.59 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.51 Typical High $8.71 | Professional | 56 · Pre-op care only | $8.32 | $8.51 | $8.71 |
Where Virginia sits
The same service costs 1.5 times more in Arizona than in Nebraska. 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· 20th of 51
$83.18
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.