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 $39.81 Median $39.81 Typical High $41.69 | Facility | None | $39.81 | $39.81 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $41.69 | Professional | None | $39.81 | $39.81 | $41.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $39.81 Median $81.28 Typical High $128.82 | Facility | None | $39.81 | $81.28 | $128.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.90 Median $36.31 Typical High $36.31 | Professional | None | $30.90 | $36.31 | $36.31 |
CareFirst Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $39.81 | Professional | None | $37.15 | $37.15 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $67.61 Typical High $97.72 | Facility | None | $40.74 | $67.61 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | None | $38.90 | $38.90 | $38.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $38.90 Median $45.71 Typical High $58.88 | Professional | None | $38.90 | $45.71 | $58.88 |
Medcost Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $70.79 | Facility | None | $39.81 | $39.81 | $70.79 |
Sentara Setting Facility Modifier None Typical Low $36.31 Median $38.90 Typical High $50.12 | Facility | None | $36.31 | $38.90 | $50.12 |
Sentara Setting Professional Modifier None Typical Low $36.31 Median $38.90 Typical High $50.12 | Professional | None | $36.31 | $38.90 | $50.12 |
United Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
United Setting Professional Modifier None Typical Low $38.90 Median $39.81 Typical High $41.69 | Professional | None | $38.90 | $39.81 | $41.69 |
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 $19.95 Median $19.95 Typical High $20.89 | Professional | 52 · Reduced service | $19.95 | $19.95 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $8.13 Typical High $8.32 | Professional | 53 · Discontinued | $7.94 | $8.13 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.03 Typical High $6.31 | Professional | 55 · Aftercare only | $6.03 | $6.03 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $3.98 Typical High $4.17 | Professional | 56 · Pre-op care only | $3.98 | $3.98 | $4.17 |
Where Virginia sits
The same service costs 1.6 times more in Arizona than in Wyoming. 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· 25th of 51
$39.81
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.