How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $9.33 Median $9.33 Typical High $9.33 | Facility | None | $9.33 | $9.33 | $9.33 |
Aetna Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | None | $9.33 | $9.33 | $9.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $9.12 | Professional | None | $8.71 | $8.71 | $9.12 |
CareFirst Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | None | $12.02 | $12.02 | $12.02 |
Cigna Setting Facility Modifier None Typical Low $9.77 Median $19.05 Typical High $23.44 | Facility | None | $9.77 | $19.05 | $23.44 |
Cigna Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | None | $9.33 | $9.33 | $9.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4.57 Median $5.50 Typical High $7.41 | Professional | None | $4.57 | $5.50 | $7.41 |
Medcost Setting Professional Modifier None Typical Low $3.31 Median $3.31 Typical High $3.55 | Professional | None | $3.31 | $3.31 | $3.55 |
Medcost Setting Facility Modifier None Typical Low $9.55 Median $9.55 Typical High $21.38 | Facility | None | $9.55 | $9.55 | $21.38 |
Medcost Setting Professional Modifier None Typical Low $2.00 Median $4.79 Typical High $10.96 | Professional | None | $2.00 | $4.79 | $10.96 |
Sentara Setting Facility Modifier None Typical Low $8.71 Median $9.77 Typical High $12.02 | Facility | None | $8.71 | $9.77 | $12.02 |
Sentara Setting Professional Modifier None Typical Low $9.12 Median $9.12 Typical High $10.47 | Professional | None | $9.12 | $9.12 | $10.47 |
United Setting Professional Modifier None Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | None | $9.12 | $9.12 | $9.12 |
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 $4.68 Median $4.68 Typical High $4.68 | Professional | 52 · Reduced service | $4.68 | $4.68 | $4.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.86 Median $1.86 Typical High $1.86 | Professional | 53 · Discontinued | $1.86 | $1.86 | $1.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.41 Median $1.41 Typical High $1.41 | Professional | 55 · Aftercare only | $1.41 | $1.41 | $1.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.93 Median $0.93 Typical High $0.93 | Professional | 56 · Pre-op care only | $0.93 | $0.93 | $0.93 |
Where Virginia sits
The same service costs 1.8 times more in Alaska than in Montana. 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· 39th of 51
$9.12
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.