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 $77.62 Median $81.28 Typical High $144.54 | Facility | None | $77.62 | $81.28 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $79.43 Typical High $81.28 | Professional | None | $77.62 | $79.43 | $81.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $66.07 Median $77.62 Typical High $77.62 | Professional | None | $66.07 | $77.62 | $77.62 |
CareFirst Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $46.77 | Professional | None | $38.02 | $38.02 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $147.91 Typical High $199.53 | Facility | None | $114.82 | $147.91 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
Kaiser Permanente Setting Professional Modifier None Typical Low $66.07 Median $81.28 Typical High $190.55 | Professional | None | $66.07 | $81.28 | $190.55 |
Medcost Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
Medcost Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $89.13 | Facility | None | $46.77 | $46.77 | $89.13 |
Sentara Setting Facility Modifier None Typical Low $79.43 Median $87.10 Typical High $102.33 | Facility | None | $79.43 | $87.10 | $102.33 |
Sentara Setting Professional Modifier None Typical Low $79.43 Median $87.10 Typical High $102.33 | Professional | None | $79.43 | $87.10 | $102.33 |
United Setting Professional Modifier None Typical Low $45.71 Median $46.77 Typical High $48.98 | Professional | None | $45.71 | $46.77 | $48.98 |
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 $38.90 Median $38.90 Typical High $40.74 | Professional | 52 · Reduced service | $38.90 | $38.90 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $15.85 Typical High $16.22 | Professional | 53 · Discontinued | $15.49 | $15.85 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $11.75 Typical High $12.30 | Professional | 55 · Aftercare only | $11.75 | $11.75 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.94 Typical High $8.13 | Professional | 56 · Pre-op care only | $7.76 | $7.94 | $8.13 |
Where Virginia sits
The same service costs 3.6 times more in Texas than in Kansas. 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· 26th of 51
$77.62
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.