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 $117.49 Median $134.90 Typical High $218.78 | Facility | None | $117.49 | $134.90 | $218.78 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $131.83 Typical High $162.18 | Professional | None | $117.49 | $131.83 | $162.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $147.91 Median $257.04 Typical High $398.11 | Facility | None | $147.91 | $257.04 | $398.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $117.49 Typical High $117.49 | Professional | None | $100.00 | $117.49 | $117.49 |
CareFirst Setting Professional Modifier None Typical Low $147.91 Median $186.21 Typical High $186.21 | Professional | None | $147.91 | $186.21 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $223.87 Typical High $302.00 | Facility | None | $169.82 | $223.87 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $100.00 Median $123.03 Typical High $338.84 | Professional | None | $100.00 | $123.03 | $338.84 |
Medcost Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
Medcost Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $354.81 | Facility | None | $295.12 | $295.12 | $354.81 |
Sentara Setting Facility Modifier None Typical Low $120.23 Median $208.93 Typical High $223.87 | Facility | None | $120.23 | $208.93 | $223.87 |
Sentara Setting Professional Modifier None Typical Low $120.23 Median $208.93 Typical High $223.87 | Professional | None | $120.23 | $208.93 | $223.87 |
United Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
United Setting Professional Modifier None Typical Low $141.25 Median $147.91 Typical High $154.88 | Professional | None | $141.25 | $147.91 | $154.88 |
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 $58.88 Median $58.88 Typical High $61.66 | Professional | 52 · Reduced service | $58.88 | $58.88 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $23.44 Typical High $24.55 | Professional | 53 · Discontinued | $23.44 | $23.44 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $18.62 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $11.75 Typical High $12.30 | Professional | 56 · Pre-op care only | $11.75 | $11.75 | $12.30 |
Where Virginia sits
The same service costs 2.0 times more in Kansas 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· 35th of 51
$148
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.