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 $213.80 Median $213.80 Typical High $223.87 | Facility | None | $213.80 | $213.80 | $223.87 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $223.87 Typical High $239.88 | Professional | None | $213.80 | $223.87 | $239.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $213.80 Median $436.52 Typical High $691.83 | Facility | None | $213.80 | $436.52 | $691.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $181.97 Median $213.80 Typical High $213.80 | Professional | None | $181.97 | $213.80 | $213.80 |
CareFirst Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $213.80 | Professional | None | $199.53 | $199.53 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $407.38 Typical High $549.54 | Facility | None | $309.03 | $407.38 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $181.97 Median $223.87 Typical High $257.04 | Professional | None | $181.97 | $223.87 | $257.04 |
Medcost Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $338.84 | Facility | None | $213.80 | $213.80 | $338.84 |
Sentara Setting Facility Modifier None Typical Low $194.98 Median $213.80 Typical High $281.84 | Facility | None | $194.98 | $213.80 | $281.84 |
Sentara Setting Professional Modifier None Typical Low $194.98 Median $213.80 Typical High $281.84 | Professional | None | $194.98 | $213.80 | $281.84 |
United Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
United Setting Professional Modifier None Typical Low $208.93 Median $213.80 Typical High $223.87 | Professional | None | $208.93 | $213.80 | $223.87 |
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 $107.15 Median $107.15 Typical High $112.20 | Professional | 52 · Reduced service | $107.15 | $107.15 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $43.65 Typical High $44.67 | Professional | 53 · Discontinued | $42.66 | $43.65 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $32.36 Typical High $33.88 | Professional | 55 · Aftercare only | $32.36 | $32.36 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $21.38 Typical High $22.39 | Professional | 56 · Pre-op care only | $21.38 | $21.38 | $22.39 |
Where Virginia sits
The same service costs 7.6 times more in Alabama than in New Mexico. 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
$214
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.