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 $10.96 Median $11.48 Typical High $18.62 | Facility | None | $10.96 | $11.48 | $18.62 |
Aetna Setting Professional Modifier None Typical Low $10.96 Median $11.48 Typical High $44.67 | Professional | None | $10.96 | $11.48 | $44.67 |
Anthem BCBS Setting Facility Modifier None Typical Low $11.22 Median $22.91 Typical High $36.31 | Facility | None | $11.22 | $22.91 | $36.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $9.33 Median $10.96 Typical High $10.96 | Professional | None | $9.33 | $10.96 | $10.96 |
CareFirst Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $11.22 | Professional | None | $10.47 | $10.47 | $11.22 |
Cigna Setting Facility Modifier None Typical Low $16.22 Median $20.89 Typical High $28.84 | Facility | None | $16.22 | $20.89 | $28.84 |
Cigna Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | None | $10.96 | $10.96 | $10.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $9.33 Median $11.48 Typical High $47.86 | Professional | None | $9.33 | $11.48 | $47.86 |
Medcost Setting Facility Modifier None Typical Low $38.90 Median $40.74 Typical High $40.74 | Facility | None | $38.90 | $40.74 | $40.74 |
Sentara Setting Facility Modifier None Typical Low $11.22 Median $41.69 Typical High $42.66 | Facility | None | $11.22 | $41.69 | $42.66 |
Sentara Setting Professional Modifier None Typical Low $11.22 Median $41.69 Typical High $42.66 | Professional | None | $11.22 | $41.69 | $42.66 |
United Setting Facility Modifier None Typical Low $10.96 Median $10.96 Typical High $10.96 | Facility | None | $10.96 | $10.96 | $10.96 |
United Setting Professional Modifier None Typical Low $10.96 Median $11.22 Typical High $11.75 | Professional | None | $10.96 | $11.22 | $11.75 |
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 $5.50 Median $5.62 Typical High $5.75 | Professional | 52 · Reduced service | $5.50 | $5.62 | $5.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.19 Median $2.24 Typical High $2.29 | Professional | 53 · Discontinued | $2.19 | $2.24 | $2.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.66 Median $1.66 Typical High $1.74 | Professional | 55 · Aftercare only | $1.66 | $1.66 | $1.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.10 Median $1.12 Typical High $1.15 | Professional | 56 · Pre-op care only | $1.10 | $1.12 | $1.15 |
Where Virginia sits
The same service costs 3.7 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
$11.22
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.