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 $74.13 Median $74.13 Typical High $79.43 | Facility | None | $74.13 | $74.13 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $75.86 Typical High $79.43 | Professional | None | $74.13 | $75.86 | $79.43 |
Anthem BCBS Setting Facility Modifier None Typical Low $75.86 Median $154.88 Typical High $245.47 | Facility | None | $75.86 | $154.88 | $245.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $63.10 Median $74.13 Typical High $74.13 | Professional | None | $63.10 | $74.13 | $74.13 |
CareFirst Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $75.86 | Professional | None | $74.13 | $74.13 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $141.25 Typical High $194.98 | Facility | None | $109.65 | $141.25 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $63.10 Median $79.43 Typical High $95.50 | Professional | None | $63.10 | $79.43 | $95.50 |
Medcost Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $120.23 | Facility | None | $75.86 | $75.86 | $120.23 |
Sentara Setting Facility Modifier None Typical Low $75.86 Median $81.28 Typical High $97.72 | Facility | None | $75.86 | $81.28 | $97.72 |
Sentara Setting Professional Modifier None Typical Low $75.86 Median $81.28 Typical High $97.72 | Professional | None | $75.86 | $81.28 | $97.72 |
United Setting Professional Modifier None Typical Low $74.13 Median $75.86 Typical High $79.43 | Professional | None | $74.13 | $75.86 | $79.43 |
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 $37.15 Median $38.02 Typical High $38.90 | Professional | 52 · Reduced service | $37.15 | $38.02 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $15.14 Typical High $15.85 | Professional | 53 · Discontinued | $14.79 | $15.14 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $11.75 | Professional | 55 · Aftercare only | $11.22 | $11.22 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.59 Typical High $7.76 | Professional | 56 · Pre-op care only | $7.41 | $7.59 | $7.76 |
Where Virginia sits
The same service costs 1.5 times more in Alaska 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· 45th of 51
$75.86
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.