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 $524.81 Median $524.81 Typical High $562.34 | Facility | None | $524.81 | $524.81 | $562.34 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $537.03 Typical High $562.34 | Professional | None | $524.81 | $537.03 | $562.34 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,096.48 Typical High $1,737.80 | Facility | None | $524.81 | $1,096.48 | $1,737.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $489.78 Typical High $489.78 | Professional | None | $416.87 | $489.78 | $489.78 |
CareFirst Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $524.81 | Professional | None | $501.19 | $501.19 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $933.25 Typical High $1,318.26 | Facility | None | $549.54 | $933.25 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $524.81 Median $616.60 Typical High $776.25 | Professional | None | $524.81 | $616.60 | $776.25 |
Medcost Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $851.14 | Facility | None | $524.81 | $524.81 | $851.14 |
Sentara Setting Facility Modifier None Typical Low $489.78 Median $524.81 Typical High $676.08 | Facility | None | $489.78 | $524.81 | $676.08 |
Sentara Setting Professional Modifier None Typical Low $489.78 Median $524.81 Typical High $676.08 | Professional | None | $489.78 | $524.81 | $676.08 |
United Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Facility | None | $524.81 | $524.81 | $524.81 |
United Setting Professional Modifier None Typical Low $512.86 Median $524.81 Typical High $562.34 | Professional | None | $512.86 | $524.81 | $562.34 |
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 $263.03 Median $269.15 Typical High $275.42 | Professional | 52 · Reduced service | $263.03 | $269.15 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $112.20 | Professional | 53 · Discontinued | $107.15 | $107.15 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $83.18 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $53.70 Typical High $56.23 | Professional | 56 · Pre-op care only | $52.48 | $53.70 | $56.23 |
Where Virginia sits
The same service costs 1.9 times more in Alaska 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
$525
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.