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 $21.38 Median $28.18 Typical High $37.15 | Facility | None | $21.38 | $28.18 | $37.15 |
Aetna Setting Professional Modifier None Typical Low $21.38 Median $22.91 Typical High $37.15 | Professional | None | $21.38 | $22.91 | $37.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $20.89 Median $43.65 Typical High $70.79 | Facility | None | $20.89 | $43.65 | $70.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $18.20 Median $21.38 Typical High $21.38 | Professional | None | $18.20 | $21.38 | $21.38 |
CareFirst Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
Cigna Setting Facility Modifier None Typical Low $31.62 Median $40.74 Typical High $56.23 | Facility | None | $31.62 | $40.74 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $18.20 Median $22.91 Typical High $40.74 | Professional | None | $18.20 | $22.91 | $40.74 |
Medcost Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $35.48 | Facility | None | $20.89 | $20.89 | $35.48 |
Sentara Setting Facility Modifier None Typical Low $22.39 Median $34.67 Typical High $36.31 | Facility | None | $22.39 | $34.67 | $36.31 |
Sentara Setting Professional Modifier None Typical Low $22.39 Median $34.67 Typical High $36.31 | Professional | None | $22.39 | $34.67 | $36.31 |
United Setting Facility Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Facility | None | $21.38 | $21.38 | $21.38 |
United Setting Professional Modifier None Typical Low $20.42 Median $20.89 Typical High $21.88 | Professional | None | $20.42 | $20.89 | $21.88 |
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 $10.72 Median $10.96 Typical High $11.22 | Professional | 52 · Reduced service | $10.72 | $10.96 | $11.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $4.37 Typical High $4.57 | Professional | 53 · Discontinued | $4.37 | $4.37 | $4.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $3.31 Typical High $3.39 | Professional | 55 · Aftercare only | $3.24 | $3.31 | $3.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.14 Median $2.19 Typical High $2.29 | Professional | 56 · Pre-op care only | $2.14 | $2.19 | $2.29 |
Where Virginia sits
The same service costs 1.9 times more in Alaska than in Maryland. 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· 32nd of 51
$21.88
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.