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 $42.66 Median $42.66 Typical High $44.67 | Facility | None | $42.66 | $42.66 | $44.67 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $44.67 | Professional | None | $42.66 | $42.66 | $44.67 |
Anthem BCBS Setting Facility Modifier None Typical Low $40.74 Median $87.10 Typical High $138.04 | Facility | None | $40.74 | $87.10 | $138.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $36.31 Median $42.66 Typical High $42.66 | Professional | None | $36.31 | $42.66 | $42.66 |
CareFirst Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $40.74 | Professional | None | $38.90 | $38.90 | $40.74 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $81.28 Typical High $109.65 | Facility | None | $61.66 | $81.28 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
Kaiser Permanente Setting Professional Modifier None Typical Low $36.31 Median $44.67 Typical High $56.23 | Professional | None | $36.31 | $44.67 | $56.23 |
Medcost Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $72.44 | Facility | None | $40.74 | $40.74 | $72.44 |
Sentara Setting Facility Modifier None Typical Low $43.65 Median $50.12 Typical High $56.23 | Facility | None | $43.65 | $50.12 | $56.23 |
Sentara Setting Professional Modifier None Typical Low $43.65 Median $50.12 Typical High $56.23 | Professional | None | $43.65 | $50.12 | $56.23 |
United Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
United Setting Professional Modifier None Typical Low $39.81 Median $40.74 Typical High $42.66 | Professional | None | $39.81 | $40.74 | $42.66 |
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 $21.38 Median $21.38 Typical High $22.39 | Professional | 52 · Reduced service | $21.38 | $21.38 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.71 Typical High $8.91 | Professional | 53 · Discontinued | $8.51 | $8.71 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.46 Typical High $6.76 | Professional | 55 · Aftercare only | $6.46 | $6.46 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $4.47 | Professional | 56 · Pre-op care only | $4.27 | $4.27 | $4.47 |
Where Virginia sits
The same service costs 575.4 times more in Alabama 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· 24th of 51
$42.66
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.