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 $31.62 Median $31.62 Typical High $33.11 | Facility | None | $31.62 | $31.62 | $33.11 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $32.36 Typical High $33.11 | Professional | None | $31.62 | $32.36 | $33.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $26.92 Median $31.62 Typical High $31.62 | Professional | None | $26.92 | $31.62 | $31.62 |
CareFirst Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $31.62 | Professional | None | $29.51 | $29.51 | $31.62 |
Cigna Setting Facility Modifier None Typical Low $46.77 Median $60.26 Typical High $83.18 | Facility | None | $46.77 | $60.26 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Kaiser Permanente Setting Professional Modifier None Typical Low $26.92 Median $33.11 Typical High $67.61 | Professional | None | $26.92 | $33.11 | $67.61 |
Medcost Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | None | $16.60 | $16.60 | $16.60 |
Medcost Setting Facility Modifier None Typical Low $31.62 Median $31.62 Typical High $51.29 | Facility | None | $31.62 | $31.62 | $51.29 |
Sentara Setting Facility Modifier None Typical Low $32.36 Median $60.26 Typical High $63.10 | Facility | None | $32.36 | $60.26 | $63.10 |
Sentara Setting Professional Modifier None Typical Low $32.36 Median $60.26 Typical High $63.10 | Professional | None | $32.36 | $60.26 | $63.10 |
United Setting Professional Modifier None Typical Low $30.90 Median $31.62 Typical High $33.11 | Professional | None | $30.90 | $31.62 | $33.11 |
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 $15.85 Median $16.22 Typical High $16.60 | Professional | 52 · Reduced service | $15.85 | $16.22 | $16.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.46 Typical High $6.61 | Professional | 53 · Discontinued | $6.31 | $6.46 | $6.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $4.79 Typical High $5.01 | Professional | 55 · Aftercare only | $4.79 | $4.79 | $5.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.24 Typical High $3.31 | Professional | 56 · Pre-op care only | $3.16 | $3.24 | $3.31 |
Where Virginia sits
The same service costs 3.8 times more in Alabama than in 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· 51st of 51
$31.62
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.