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 $18.62 Median $19.50 Typical High $23.99 | Facility | None | $18.62 | $19.50 | $23.99 |
Aetna Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $20.42 | Professional | None | $18.62 | $18.62 | $20.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $18.20 Median $37.15 Typical High $60.26 | Facility | None | $18.20 | $37.15 | $60.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $15.85 Median $18.62 Typical High $18.62 | Professional | None | $15.85 | $18.62 | $18.62 |
CareFirst Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $18.20 | Professional | None | $16.98 | $16.98 | $18.20 |
Cigna Setting Facility Modifier None Typical Low $26.92 Median $34.67 Typical High $47.86 | Facility | None | $26.92 | $34.67 | $47.86 |
Cigna Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | None | $18.62 | $18.62 | $18.62 |
Kaiser Permanente Setting Professional Modifier None Typical Low $15.85 Median $18.62 Typical High $22.39 | Professional | None | $15.85 | $18.62 | $22.39 |
Medcost Setting Facility Modifier None Typical Low $18.20 Median $18.20 Typical High $29.51 | Facility | None | $18.20 | $18.20 | $29.51 |
Sentara Setting Facility Modifier None Typical Low $17.78 Median $18.62 Typical High $23.99 | Facility | None | $17.78 | $18.62 | $23.99 |
Sentara Setting Professional Modifier None Typical Low $17.78 Median $18.62 Typical High $23.99 | Professional | None | $17.78 | $18.62 | $23.99 |
United Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Facility | None | $18.62 | $18.62 | $18.62 |
United Setting Professional Modifier None Typical Low $17.78 Median $18.20 Typical High $19.05 | Professional | None | $17.78 | $18.20 | $19.05 |
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 $9.33 Median $9.33 Typical High $9.77 | Professional | 52 · Reduced service | $9.33 | $9.33 | $9.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $3.72 Typical High $3.89 | Professional | 53 · Discontinued | $3.72 | $3.72 | $3.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $2.82 Typical High $2.88 | Professional | 55 · Aftercare only | $2.75 | $2.82 | $2.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $1.86 Typical High $1.95 | Professional | 56 · Pre-op care only | $1.86 | $1.86 | $1.95 |
Where Virginia sits
The same service costs 1.5 times more in Alaska than in Rhode Island. 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· 21st of 51
$18.62
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.