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 $173.78 Median $173.78 Typical High $181.97 | Facility | None | $173.78 | $173.78 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $181.97 | Professional | None | $173.78 | $173.78 | $181.97 |
Anthem BCBS Setting Professional Modifier None Typical Low $147.91 Median $173.78 Typical High $173.78 | Professional | None | $147.91 | $173.78 | $173.78 |
CareFirst Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $91.20 | Professional | None | $70.79 | $70.79 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $323.59 Typical High $446.68 | Facility | None | $251.19 | $323.59 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $147.91 Median $181.97 Typical High $239.88 | Professional | None | $147.91 | $181.97 | $239.88 |
Medcost Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $6.92 | Professional | None | $6.92 | $6.92 | $6.92 |
Medcost Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $134.90 | Facility | None | $91.20 | $91.20 | $134.90 |
Sentara Setting Facility Modifier None Typical Low $177.83 Median $208.93 Typical High $223.87 | Facility | None | $177.83 | $208.93 | $223.87 |
Sentara Setting Professional Modifier None Typical Low $177.83 Median $208.93 Typical High $223.87 | Professional | None | $177.83 | $208.93 | $223.87 |
United Setting Professional Modifier None Typical Low $89.13 Median $91.20 Typical High $95.50 | Professional | None | $89.13 | $91.20 | $95.50 |
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 $87.10 Median $87.10 Typical High $91.20 | Professional | 52 · Reduced service | $87.10 | $87.10 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $34.67 Typical High $36.31 | Professional | 53 · Discontinued | $34.67 | $34.67 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $26.30 Typical High $26.92 | Professional | 55 · Aftercare only | $25.70 | $26.30 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.38 Typical High $18.20 | Professional | 56 · Pre-op care only | $17.38 | $17.38 | $18.20 |
Where Virginia sits
The same service costs 3.2 times more in Wyoming than in Oklahoma. 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· 22nd of 51
$174
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.