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 $17.78 Median $18.62 Typical High $30.20 | Facility | None | $17.78 | $18.62 | $30.20 |
Aetna Setting Professional Modifier None Typical Low $17.78 Median $18.62 Typical High $22.39 | Professional | None | $17.78 | $18.62 | $22.39 |
Anthem BCBS Setting Facility Modifier None Typical Low $17.38 Median $36.31 Typical High $58.88 | Facility | None | $17.38 | $36.31 | $58.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $15.14 Median $17.78 Typical High $17.78 | Professional | None | $15.14 | $17.78 | $17.78 |
CareFirst Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.78 | Professional | None | $17.38 | $17.38 | $17.78 |
Cigna Setting Facility Modifier None Typical Low $26.30 Median $33.88 Typical High $46.77 | Facility | None | $26.30 | $33.88 | $46.77 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | None | $17.78 | $17.78 | $17.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $15.14 Median $18.62 Typical High $26.92 | Professional | None | $15.14 | $18.62 | $26.92 |
Medcost Setting Facility Modifier None Typical Low $17.78 Median $17.78 Typical High $28.84 | Facility | None | $17.78 | $17.78 | $28.84 |
Sentara Setting Facility Modifier None Typical Low $18.20 Median $22.39 Typical High $25.12 | Facility | None | $18.20 | $22.39 | $25.12 |
Sentara Setting Professional Modifier None Typical Low $18.20 Median $22.39 Typical High $25.12 | Professional | None | $18.20 | $22.39 | $25.12 |
United Setting Professional Modifier None Typical Low $16.98 Median $17.38 Typical High $18.62 | Professional | None | $16.98 | $17.38 | $18.62 |
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 $8.91 Median $9.12 Typical High $9.33 | Professional | 52 · Reduced service | $8.91 | $9.12 | $9.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.55 Median $3.63 Typical High $3.80 | Professional | 53 · Discontinued | $3.55 | $3.63 | $3.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.69 Median $2.69 Typical High $2.82 | Professional | 55 · Aftercare only | $2.69 | $2.69 | $2.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.78 Median $1.82 Typical High $1.86 | Professional | 56 · Pre-op care only | $1.78 | $1.82 | $1.86 |
Where Virginia sits
The same service costs 1.5 times more in Alaska than in Rhode Island. 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
$17.78
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.