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 $12.88 Median $13.49 Typical High $23.99 | Facility | None | $12.88 | $13.49 | $23.99 |
Aetna Setting Professional Modifier None Typical Low $12.88 Median $13.18 Typical High $14.13 | Professional | None | $12.88 | $13.18 | $14.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.96 Median $12.88 Typical High $12.88 | Professional | None | $10.96 | $12.88 | $12.88 |
CareFirst Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $14.79 | Professional | None | $12.02 | $12.02 | $14.79 |
Cigna Setting Facility Modifier None Typical Low $19.05 Median $24.55 Typical High $33.88 | Facility | None | $19.05 | $24.55 | $33.88 |
Cigna Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | None | $12.88 | $12.88 | $12.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $10.96 Median $13.49 Typical High $29.51 | Professional | None | $10.96 | $13.49 | $29.51 |
Medcost Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | None | $3.89 | $3.89 | $3.89 |
Medcost Setting Facility Modifier None Typical Low $16.98 Median $26.30 Typical High $26.30 | Facility | None | $16.98 | $26.30 | $26.30 |
Sentara Setting Facility Modifier None Typical Low $13.18 Median $26.30 Typical High $28.18 | Facility | None | $13.18 | $26.30 | $28.18 |
Sentara Setting Professional Modifier None Typical Low $13.18 Median $26.30 Typical High $28.18 | Professional | None | $13.18 | $26.30 | $28.18 |
United Setting Professional Modifier None Typical Low $14.45 Median $14.79 Typical High $15.49 | Professional | None | $14.45 | $14.79 | $15.49 |
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 $6.46 Median $6.61 Typical High $6.76 | Professional | 52 · Reduced service | $6.46 | $6.61 | $6.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.57 Median $2.63 Typical High $2.69 | Professional | 53 · Discontinued | $2.57 | $2.63 | $2.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.95 Median $1.95 Typical High $2.04 | Professional | 55 · Aftercare only | $1.95 | $1.95 | $2.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.29 Median $1.32 Typical High $1.35 | Professional | 56 · Pre-op care only | $1.29 | $1.32 | $1.35 |
Where Virginia sits
The same service costs 2.0 times more in South Carolina than in Kentucky. 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
$13.49
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.