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 $512.86 Median $512.86 Typical High $537.03 | Facility | None | $512.86 | $512.86 | $537.03 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $537.03 | Professional | None | $512.86 | $512.86 | $537.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $501.19 Median $1,047.13 Typical High $1,659.59 | Facility | None | $501.19 | $1,047.13 | $1,659.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $436.52 Median $512.86 Typical High $512.86 | Professional | None | $436.52 | $512.86 | $512.86 |
CareFirst Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $501.19 | Professional | None | $457.09 | $457.09 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $977.24 Typical High $1,318.26 | Facility | None | $741.31 | $977.24 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $436.52 Median $537.03 Typical High $616.60 | Professional | None | $436.52 | $537.03 | $616.60 |
Medcost Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $630.96 | Facility | None | $501.19 | $501.19 | $630.96 |
Sentara Setting Facility Modifier None Typical Low $467.74 Median $512.86 Typical High $676.08 | Facility | None | $467.74 | $512.86 | $676.08 |
Sentara Setting Professional Modifier None Typical Low $467.74 Median $512.86 Typical High $676.08 | Professional | None | $467.74 | $512.86 | $676.08 |
United Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
United Setting Professional Modifier None Typical Low $478.63 Median $501.19 Typical High $524.81 | Professional | None | $478.63 | $501.19 | $524.81 |
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 $257.04 Median $257.04 Typical High $269.15 | Professional | 52 · Reduced service | $257.04 | $257.04 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $104.71 Typical High $107.15 | Professional | 53 · Discontinued | $102.33 | $104.71 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $81.28 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $53.70 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $53.70 |
Where Virginia sits
The same service costs 1.6 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· 24th of 51
$513
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.