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 $24.55 Median $24.55 Typical High $25.70 | Facility | None | $24.55 | $24.55 | $25.70 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $25.70 Typical High $41.69 | Professional | None | $24.55 | $25.70 | $41.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $23.99 Median $50.12 Typical High $81.28 | Facility | None | $23.99 | $50.12 | $81.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $20.89 Median $24.55 Typical High $24.55 | Professional | None | $20.89 | $24.55 | $24.55 |
CareFirst Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $23.99 | Professional | None | $22.39 | $22.39 | $23.99 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $46.77 Typical High $64.57 | Facility | None | $36.31 | $46.77 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $14.45 Median $24.55 Typical High $29.51 | Professional | None | $14.45 | $24.55 | $29.51 |
Medcost Setting Facility Modifier None Typical Low $23.99 Median $23.99 Typical High $39.81 | Facility | None | $23.99 | $23.99 | $39.81 |
Sentara Setting Facility Modifier None Typical Low $22.91 Median $24.55 Typical High $32.36 | Facility | None | $22.91 | $24.55 | $32.36 |
Sentara Setting Professional Modifier None Typical Low $22.91 Median $24.55 Typical High $32.36 | Professional | None | $22.91 | $24.55 | $32.36 |
United Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
United Setting Professional Modifier None Typical Low $23.44 Median $23.99 Typical High $25.12 | Professional | None | $23.44 | $23.99 | $25.12 |
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 $12.30 Median $12.59 Typical High $12.88 | Professional | 52 · Reduced service | $12.30 | $12.59 | $12.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $5.01 Typical High $5.13 | Professional | 53 · Discontinued | $4.90 | $5.01 | $5.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.72 Typical High $3.89 | Professional | 55 · Aftercare only | $3.72 | $3.72 | $3.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.51 Typical High $2.57 | Professional | 56 · Pre-op care only | $2.45 | $2.51 | $2.57 |
Where Virginia sits
The same service costs 1.6 times more in Alaska than in Mississippi. 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· 35th of 51
$24.55
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.