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 $11.48 Median $11.48 Typical High $12.02 | Facility | None | $11.48 | $11.48 | $12.02 |
Aetna Setting Professional Modifier None Typical Low $11.48 Median $12.02 Typical High $13.18 | Professional | None | $11.48 | $12.02 | $13.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $11.48 Median $23.44 Typical High $37.15 | Facility | None | $11.48 | $23.44 | $37.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $9.77 Median $11.48 Typical High $11.48 | Professional | None | $9.77 | $11.48 | $11.48 |
CareFirst Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $11.48 | Professional | None | $10.96 | $10.96 | $11.48 |
Cigna Setting Facility Modifier None Typical Low $16.60 Median $21.38 Typical High $29.51 | Facility | None | $16.60 | $21.38 | $29.51 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | None | $11.48 | $11.48 | $11.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $9.77 Median $12.02 Typical High $13.80 | Professional | None | $9.77 | $12.02 | $13.80 |
Medcost Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | None | $15.85 | $15.85 | $15.85 |
Medcost Setting Facility Modifier None Typical Low $11.75 Median $11.75 Typical High $19.95 | Facility | None | $11.75 | $11.75 | $19.95 |
Sentara Setting Facility Modifier None Typical Low $10.96 Median $12.30 Typical High $14.79 | Facility | None | $10.96 | $12.30 | $14.79 |
Sentara Setting Professional Modifier None Typical Low $10.96 Median $12.30 Typical High $14.79 | Professional | None | $10.96 | $12.30 | $14.79 |
United Setting Facility Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Facility | None | $11.48 | $11.48 | $11.48 |
United Setting Professional Modifier None Typical Low $11.22 Median $11.48 Typical High $12.02 | Professional | None | $11.22 | $11.48 | $12.02 |
2 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 55 · Aftercare only Typical Low $1.70 Median $1.74 Typical High $1.78 | Professional | 55 · Aftercare only | $1.70 | $1.74 | $1.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.15 Typical High $1.20 | Professional | 56 · Pre-op care only | $1.12 | $1.15 | $1.20 |
Where Virginia sits
The same service costs 1.5 times more in Alaska than in West Virginia. 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· 44th of 51
$11.48
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.