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 $0.62 Median $11.22 Typical High $17.38 | Facility | None | $0.62 | $11.22 | $17.38 |
Aetna Setting Professional Modifier None Typical Low $11.22 Median $11.75 Typical High $19.05 | Professional | None | $11.22 | $11.75 | $19.05 |
Anthem BCBS Setting Professional Modifier None Typical Low $9.55 Median $11.22 Typical High $11.22 | Professional | None | $9.55 | $11.22 | $11.22 |
CareFirst Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $11.22 | Professional | None | $7.76 | $7.76 | $11.22 |
Cigna Setting Facility Modifier None Typical Low $16.22 Median $20.89 Typical High $28.84 | Facility | None | $16.22 | $20.89 | $28.84 |
Cigna Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | None | $11.22 | $11.22 | $11.22 |
Kaiser Permanente Setting Professional Modifier None Typical Low $9.55 Median $11.75 Typical High $19.05 | Professional | None | $9.55 | $11.75 | $19.05 |
Medcost Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $1.38 | Professional | None | $1.38 | $1.38 | $1.38 |
Medcost Setting Facility Modifier None Typical Low $15.14 Median $15.14 Typical High $19.50 | Facility | None | $15.14 | $15.14 | $19.50 |
Sentara Setting Facility Modifier None Typical Low $11.48 Median $15.49 Typical High $16.60 | Facility | None | $11.48 | $15.49 | $16.60 |
Sentara Setting Professional Modifier None Typical Low $11.48 Median $15.49 Typical High $16.60 | Professional | None | $11.48 | $15.49 | $16.60 |
United Setting Professional Modifier None Typical Low $10.96 Median $11.22 Typical High $12.02 | Professional | None | $10.96 | $11.22 | $12.02 |
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 $5.62 Median $5.62 Typical High $5.89 | Professional | 52 · Reduced service | $5.62 | $5.62 | $5.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.24 Median $2.24 Typical High $2.34 | Professional | 53 · Discontinued | $2.24 | $2.24 | $2.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.66 Median $1.70 Typical High $1.78 | Professional | 55 · Aftercare only | $1.66 | $1.70 | $1.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.12 Typical High $1.17 | Professional | 56 · Pre-op care only | $1.12 | $1.12 | $1.17 |
Where Virginia sits
The same service costs 3.3 times more in Alaska than in Texas. 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· 34th of 51
$11.22
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.