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 $20.42 Median $21.38 Typical High $38.02 | Facility | None | $20.42 | $21.38 | $38.02 |
Aetna Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $21.38 | Professional | None | $20.42 | $20.42 | $21.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $32.36 Median $51.29 Typical High $81.28 | Facility | None | $32.36 | $51.29 | $81.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.50 Median $20.42 Typical High $20.42 | Professional | None | $19.50 | $20.42 | $20.42 |
CareFirst Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $32.36 | Professional | None | $22.91 | $22.91 | $32.36 |
Cigna Setting Facility Modifier None Typical Low $29.51 Median $41.69 Typical High $52.48 | Facility | None | $29.51 | $41.69 | $52.48 |
Cigna Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | None | $20.42 | $20.42 | $20.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $17.38 Median $21.38 Typical High $89.13 | Professional | None | $17.38 | $21.38 | $89.13 |
Medcost Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Facility | None | $32.36 | $32.36 | $32.36 |
Sentara Setting Facility Modifier None Typical Low $20.89 Median $79.43 Typical High $85.11 | Facility | None | $20.89 | $79.43 | $85.11 |
Sentara Setting Professional Modifier None Typical Low $20.89 Median $79.43 Typical High $85.11 | Professional | None | $20.89 | $79.43 | $85.11 |
United Setting Professional Modifier None Typical Low $30.90 Median $32.36 Typical High $33.88 | Professional | None | $30.90 | $32.36 | $33.88 |
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 $10.23 Median $10.23 Typical High $10.72 | Professional | 52 · Reduced service | $10.23 | $10.23 | $10.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $4.07 Typical High $4.27 | Professional | 53 · Discontinued | $4.07 | $4.07 | $4.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $3.09 Typical High $3.24 | Professional | 55 · Aftercare only | $3.02 | $3.09 | $3.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.04 Typical High $2.14 | Professional | 56 · Pre-op care only | $2.04 | $2.04 | $2.14 |
Where Virginia sits
The same service costs 3.8 times more in Oklahoma than in Delaware. 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· 29th of 51
$31.62
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.