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 $562.34 Median $588.84 Typical High $741.31 | Facility | None | $562.34 | $588.84 | $741.31 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $588.84 Typical High $954.99 | Professional | None | $562.34 | $588.84 | $954.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $660.69 Median $1,202.26 Typical High $1,862.09 | Facility | None | $660.69 | $1,202.26 | $1,862.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $478.63 Median $562.34 Typical High $562.34 | Professional | None | $478.63 | $562.34 | $562.34 |
CareFirst Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $660.69 | Professional | None | $501.19 | $501.19 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $1,071.52 Typical High $1,479.11 | Facility | None | $831.76 | $1,071.52 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
Kaiser Permanente Setting Professional Modifier None Typical Low $478.63 Median $588.84 Typical High $1,819.70 | Professional | None | $478.63 | $588.84 | $1,819.70 |
Medcost Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $1,380.38 | Facility | None | $660.69 | $660.69 | $1,380.38 |
Sentara Setting Facility Modifier None Typical Low $575.44 Median $1,479.11 Typical High $1,584.89 | Facility | None | $575.44 | $1,479.11 | $1,584.89 |
Sentara Setting Professional Modifier None Typical Low $575.44 Median $1,479.11 Typical High $1,584.89 | Professional | None | $575.44 | $1,479.11 | $1,584.89 |
United Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Facility | None | $562.34 | $562.34 | $562.34 |
United Setting Professional Modifier None Typical Low $630.96 Median $660.69 Typical High $691.83 | Professional | None | $630.96 | $660.69 | $691.83 |
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 $281.84 Median $288.40 Typical High $295.12 | Professional | 52 · Reduced service | $281.84 | $288.40 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $114.82 Typical High $117.49 | Professional | 53 · Discontinued | $112.20 | $114.82 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $89.13 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $57.54 Typical High $58.88 | Professional | 56 · Pre-op care only | $56.23 | $57.54 | $58.88 |
Where Virginia sits
The same service costs 2.7 times more in Wyoming than in Georgia. 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· 33rd of 51
$661
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.