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 $120.23 Median $120.23 Typical High $125.89 | Facility | None | $120.23 | $120.23 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $123.03 Typical High $125.89 | Professional | None | $120.23 | $123.03 | $125.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $120.23 Median $245.47 Typical High $398.11 | Facility | None | $120.23 | $245.47 | $398.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $102.33 Median $120.23 Typical High $120.23 | Professional | None | $102.33 | $120.23 | $120.23 |
CareFirst Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $120.23 | Professional | None | $109.65 | $109.65 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $229.09 Typical High $316.23 | Facility | None | $177.83 | $229.09 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $102.33 Median $125.89 Typical High $144.54 | Professional | None | $102.33 | $125.89 | $144.54 |
Medcost Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $194.98 | Facility | None | $120.23 | $120.23 | $194.98 |
Sentara Setting Facility Modifier None Typical Low $112.20 Median $125.89 Typical High $158.49 | Facility | None | $112.20 | $125.89 | $158.49 |
Sentara Setting Professional Modifier None Typical Low $112.20 Median $125.89 Typical High $158.49 | Professional | None | $112.20 | $125.89 | $158.49 |
United Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
United Setting Professional Modifier None Typical Low $117.49 Median $120.23 Typical High $125.89 | Professional | None | $117.49 | $120.23 | $125.89 |
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 $60.26 Median $61.66 Typical High $63.10 | Professional | 52 · Reduced service | $60.26 | $61.66 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $24.55 Typical High $25.12 | Professional | 53 · Discontinued | $23.99 | $24.55 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $19.05 | Professional | 55 · Aftercare only | $18.20 | $18.20 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.30 Typical High $12.59 | Professional | 56 · Pre-op care only | $12.02 | $12.30 | $12.59 |
Where Virginia sits
The same service costs 1.7 times more in Arizona 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· 30th of 51
$120
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.