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 $144.54 Median $144.54 Typical High $151.36 | Facility | None | $144.54 | $144.54 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $147.91 Typical High $151.36 | Professional | None | $144.54 | $147.91 | $151.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $141.25 Median $295.12 Typical High $478.63 | Facility | None | $141.25 | $295.12 | $478.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $123.03 Median $144.54 Typical High $144.54 | Professional | None | $123.03 | $144.54 | $144.54 |
CareFirst Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $141.25 | Professional | None | $131.83 | $131.83 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $275.42 Typical High $380.19 | Facility | None | $213.80 | $275.42 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $123.03 Median $151.36 Typical High $194.98 | Professional | None | $123.03 | $151.36 | $194.98 |
Medcost Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $234.42 | Facility | None | $141.25 | $141.25 | $234.42 |
Sentara Setting Facility Modifier None Typical Low $147.91 Median $162.18 Typical High $190.55 | Facility | None | $147.91 | $162.18 | $190.55 |
Sentara Setting Professional Modifier None Typical Low $147.91 Median $162.18 Typical High $190.55 | Professional | None | $147.91 | $162.18 | $190.55 |
United Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
United Setting Professional Modifier None Typical Low $141.25 Median $147.91 Typical High $181.97 | Professional | None | $141.25 | $147.91 | $181.97 |
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 $72.44 Median $74.13 Typical High $75.86 | Professional | 52 · Reduced service | $72.44 | $74.13 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $29.51 Typical High $30.20 | Professional | 53 · Discontinued | $28.84 | $29.51 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $21.88 Typical High $22.91 | Professional | 55 · Aftercare only | $21.88 | $21.88 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.79 Typical High $15.14 | Professional | 56 · Pre-op care only | $14.45 | $14.79 | $15.14 |
Where Virginia sits
The same service costs 1.5 times more in Arizona than in Oregon. 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.