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 $109.65 Median $109.65 Typical High $114.82 | Facility | None | $109.65 | $109.65 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $114.82 | Professional | None | $109.65 | $109.65 | $114.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $104.71 Median $223.87 Typical High $363.08 | Facility | None | $104.71 | $223.87 | $363.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $93.33 Median $109.65 Typical High $109.65 | Professional | None | $93.33 | $109.65 | $109.65 |
CareFirst Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $104.71 | Professional | None | $100.00 | $100.00 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $208.93 Typical High $281.84 | Facility | None | $158.49 | $208.93 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $93.33 Median $114.82 Typical High $131.83 | Professional | None | $93.33 | $114.82 | $131.83 |
Medcost Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $165.96 | Facility | None | $104.71 | $104.71 | $165.96 |
Sentara Setting Facility Modifier None Typical Low $104.71 Median $117.49 Typical High $144.54 | Facility | None | $104.71 | $117.49 | $144.54 |
Sentara Setting Professional Modifier None Typical Low $104.71 Median $117.49 Typical High $144.54 | Professional | None | $104.71 | $117.49 | $144.54 |
United Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
United Setting Professional Modifier None Typical Low $102.33 Median $104.71 Typical High $109.65 | Professional | None | $102.33 | $104.71 | $109.65 |
5 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 $54.95 Median $54.95 Typical High $57.54 | Professional | 52 · Reduced service | $54.95 | $54.95 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $22.39 Typical High $22.91 | Professional | 53 · Discontinued | $21.88 | $22.39 | $22.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $83.18 Typical High $87.10 | Professional | 54 · Surgery only | $83.18 | $83.18 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $16.60 Typical High $17.38 | Professional | 55 · Aftercare only | $16.60 | $16.60 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $11.48 | Professional | 56 · Pre-op care only | $10.96 | $10.96 | $11.48 |
Where Virginia sits
The same service costs 5.0 times more in Alabama than in Maryland. 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· 44th of 51
$110
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.