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 $19.50 Median $20.42 Typical High $25.12 | Facility | None | $19.50 | $20.42 | $25.12 |
Aetna Setting Professional Modifier None Typical Low $19.50 Median $19.95 Typical High $21.38 | Professional | None | $19.50 | $19.95 | $21.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $18.62 Median $38.90 Typical High $63.10 | Facility | None | $18.62 | $38.90 | $63.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $16.22 Median $19.50 Typical High $19.50 | Professional | None | $16.22 | $19.50 | $19.50 |
CareFirst Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $18.62 | Professional | None | $17.38 | $17.38 | $18.62 |
Cigna Setting Facility Modifier None Typical Low $28.18 Median $36.31 Typical High $50.12 | Facility | None | $28.18 | $36.31 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | None | $19.50 | $19.50 | $19.50 |
Kaiser Permanente Setting Professional Modifier None Typical Low $16.22 Median $20.42 Typical High $26.92 | Professional | None | $16.22 | $20.42 | $26.92 |
Medcost Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $33.88 | Facility | None | $18.62 | $18.62 | $33.88 |
Sentara Setting Facility Modifier None Typical Low $19.95 Median $23.44 Typical High $25.12 | Facility | None | $19.95 | $23.44 | $25.12 |
Sentara Setting Professional Modifier None Typical Low $19.95 Median $23.44 Typical High $25.12 | Professional | None | $19.95 | $23.44 | $25.12 |
United Setting Facility Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Facility | None | $19.50 | $19.50 | $19.50 |
United Setting Professional Modifier None Typical Low $18.20 Median $18.62 Typical High $19.50 | Professional | None | $18.20 | $18.62 | $19.50 |
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 $9.55 Median $9.77 Typical High $10.00 | Professional | 52 · Reduced service | $9.55 | $9.77 | $10.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.89 Median $3.89 Typical High $4.07 | Professional | 53 · Discontinued | $3.89 | $3.89 | $4.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.88 Median $2.95 Typical High $3.02 | Professional | 55 · Aftercare only | $2.88 | $2.95 | $3.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $1.95 Typical High $2.04 | Professional | 56 · Pre-op care only | $1.95 | $1.95 | $2.04 |
Where Virginia sits
The same service costs 1.9 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· 43rd of 51
$19.50
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.