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 $89.13 Median $95.50 Typical High $95.50 | Facility | None | $89.13 | $95.50 | $95.50 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $91.20 Typical High $95.50 | Professional | None | $89.13 | $91.20 | $95.50 |
Anthem BCBS Setting Facility Modifier None Typical Low $93.33 Median $186.21 Typical High $295.12 | Facility | None | $93.33 | $186.21 | $295.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $75.86 Median $89.13 Typical High $89.13 | Professional | None | $75.86 | $89.13 | $89.13 |
CareFirst Setting Professional Modifier None Typical Low $93.33 Median $95.50 Typical High $95.50 | Professional | None | $93.33 | $95.50 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $169.82 Typical High $234.42 | Facility | None | $131.83 | $169.82 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $75.86 Median $95.50 Typical High $190.55 | Professional | None | $75.86 | $95.50 | $190.55 |
Medcost Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $144.54 | Facility | None | $93.33 | $93.33 | $144.54 |
Sentara Setting Facility Modifier None Typical Low $93.33 Median $162.18 Typical High $169.82 | Facility | None | $93.33 | $162.18 | $169.82 |
Sentara Setting Professional Modifier None Typical Low $93.33 Median $162.18 Typical High $169.82 | Professional | None | $93.33 | $162.18 | $169.82 |
United Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
United Setting Professional Modifier None Typical Low $89.13 Median $93.33 Typical High $97.72 | Professional | None | $89.13 | $93.33 | $97.72 |
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 $44.67 Median $45.71 Typical High $46.77 | Professional | 52 · Reduced service | $44.67 | $45.71 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $18.20 Typical High $19.05 | Professional | 53 · Discontinued | $18.20 | $18.20 | $19.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $13.49 Typical High $14.13 | Professional | 55 · Aftercare only | $13.49 | $13.49 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $9.12 Typical High $9.33 | Professional | 56 · Pre-op care only | $8.91 | $9.12 | $9.33 |
Where Virginia sits
The same service costs 5.9 times more in Alabama than in Florida. 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· 43rd of 51
$93.33
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.