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 $316.23 Median $316.23 Typical High $338.84 | Facility | None | $316.23 | $316.23 | $338.84 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $323.59 Typical High $338.84 | Professional | None | $316.23 | $323.59 | $338.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $309.03 Median $645.65 Typical High $1,047.13 | Facility | None | $309.03 | $645.65 | $1,047.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $269.15 Median $316.23 Typical High $316.23 | Professional | None | $269.15 | $316.23 | $316.23 |
CareFirst Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $309.03 | Professional | None | $288.40 | $288.40 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $602.56 Typical High $831.76 | Facility | None | $467.74 | $602.56 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $269.15 Median $338.84 Typical High $380.19 | Professional | None | $269.15 | $338.84 | $380.19 |
Medcost Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $436.52 | Facility | None | $309.03 | $309.03 | $436.52 |
Sentara Setting Facility Modifier None Typical Low $295.12 Median $316.23 Typical High $416.87 | Facility | None | $295.12 | $316.23 | $416.87 |
Sentara Setting Professional Modifier None Typical Low $295.12 Median $316.23 Typical High $416.87 | Professional | None | $295.12 | $316.23 | $416.87 |
United Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
United Setting Professional Modifier None Typical Low $302.00 Median $309.03 Typical High $331.13 | Professional | None | $302.00 | $309.03 | $331.13 |
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 $158.49 Median $162.18 Typical High $165.96 | Professional | 52 · Reduced service | $158.49 | $162.18 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $64.57 Typical High $67.61 | Professional | 53 · Discontinued | $64.57 | $64.57 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $47.86 Typical High $50.12 | Professional | 55 · Aftercare only | $47.86 | $47.86 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $32.36 Typical High $33.88 | Professional | 56 · Pre-op care only | $31.62 | $32.36 | $33.88 |
Where Virginia sits
The same service costs 1.6 times more in Arizona than in Rhode Island. 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
$316
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.