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 $41.69 Median $77.62 Typical High $331.13 | Facility | None | $41.69 | $77.62 | $331.13 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $43.65 | Professional | None | $41.69 | $41.69 | $43.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $50.12 Median $89.13 Typical High $138.04 | Facility | None | $50.12 | $89.13 | $138.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $35.48 Median $41.69 Typical High $41.69 | Professional | None | $35.48 | $41.69 | $41.69 |
CareFirst Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $50.12 | Professional | None | $30.20 | $30.20 | $50.12 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $83.18 Typical High $107.15 | Facility | None | $60.26 | $83.18 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $35.48 Median $43.65 Typical High $218.78 | Professional | None | $35.48 | $43.65 | $218.78 |
Medcost Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
Medcost Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $346.74 | Facility | None | $288.40 | $288.40 | $346.74 |
Sentara Setting Facility Modifier None Typical Low $42.66 Median $169.82 Typical High $181.97 | Facility | None | $42.66 | $169.82 | $181.97 |
Sentara Setting Professional Modifier None Typical Low $42.66 Median $169.82 Typical High $181.97 | Professional | None | $42.66 | $169.82 | $181.97 |
United Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
United Setting Professional Modifier None Typical Low $50.12 Median $52.48 Typical High $64.57 | Professional | None | $50.12 | $52.48 | $64.57 |
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 $20.89 Median $20.89 Typical High $21.88 | Professional | 52 · Reduced service | $20.89 | $20.89 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $8.32 Typical High $8.71 | Professional | 53 · Discontinued | $8.32 | $8.32 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.31 Typical High $6.46 | Professional | 55 · Aftercare only | $6.17 | $6.31 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.17 Typical High $4.37 | Professional | 56 · Pre-op care only | $4.17 | $4.17 | $4.37 |
Where Virginia sits
The same service costs 3.9 times more in Wyoming than in Georgia. 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· 38th of 51
$50.12
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.