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 $398.11 Median $416.87 Typical High $758.58 | Facility | None | $398.11 | $416.87 | $758.58 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $407.38 Typical High $416.87 | Professional | None | $398.11 | $407.38 | $416.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $812.83 Typical High $1,318.26 | Facility | None | $389.05 | $812.83 | $1,318.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $338.84 Median $398.11 Typical High $398.11 | Professional | None | $338.84 | $398.11 | $398.11 |
CareFirst Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $389.05 | Professional | None | $371.54 | $371.54 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $758.58 Typical High $1,047.13 | Facility | None | $588.84 | $758.58 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $338.84 Median $416.87 Typical High $478.63 | Professional | None | $338.84 | $416.87 | $478.63 |
Medcost Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
Medcost Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $549.54 | Facility | None | $389.05 | $389.05 | $549.54 |
Sentara Setting Facility Modifier None Typical Low $371.54 Median $416.87 Typical High $524.81 | Facility | None | $371.54 | $416.87 | $524.81 |
Sentara Setting Professional Modifier None Typical Low $371.54 Median $416.87 Typical High $524.81 | Professional | None | $371.54 | $416.87 | $524.81 |
United Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
United Setting Professional Modifier None Typical Low $380.19 Median $389.05 Typical High $407.38 | Professional | None | $380.19 | $389.05 | $407.38 |
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 $199.53 Median $204.17 Typical High $208.93 | Professional | 52 · Reduced service | $199.53 | $204.17 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $81.28 Typical High $85.11 | Professional | 53 · Discontinued | $79.43 | $81.28 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $63.10 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $40.74 Typical High $41.69 | Professional | 56 · Pre-op care only | $39.81 | $40.74 | $41.69 |
Where Virginia sits
The same service costs 2.8 times more in Arizona than in Alabama. 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
$398
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.