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 $25.12 Median $43.65 Typical High $83.18 | Facility | None | $25.12 | $43.65 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $26.30 Typical High $30.90 | Professional | None | $25.12 | $26.30 | $30.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
CareFirst Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | None | $16.60 | $16.60 | $16.60 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $50.12 Typical High $64.57 | Facility | None | $36.31 | $50.12 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $20.89 Median $25.12 Typical High $45.71 | Professional | None | $20.89 | $25.12 | $45.71 |
Medcost Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $223.87 | Professional | None | $44.67 | $44.67 | $223.87 |
Medcost Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $47.86 | Facility | None | $40.74 | $40.74 | $47.86 |
Medcost Setting Professional Modifier None Typical Low $28.18 Median $38.90 Typical High $199.53 | Professional | None | $28.18 | $38.90 | $199.53 |
Sentara Setting Facility Modifier None Typical Low $25.70 Median $41.69 Typical High $44.67 | Facility | None | $25.70 | $41.69 | $44.67 |
Sentara Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $44.67 | Professional | None | $25.12 | $25.12 | $44.67 |
United Setting Professional Modifier None Typical Low $16.60 Median $17.78 Typical High $18.62 | Professional | None | $16.60 | $17.78 | $18.62 |
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 $12.30 Median $12.30 Typical High $13.18 | Professional | 52 · Reduced service | $12.30 | $12.30 | $13.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $5.01 Typical High $5.25 | Professional | 53 · Discontinued | $5.01 | $5.01 | $5.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.72 Typical High $3.89 | Professional | 55 · Aftercare only | $3.72 | $3.72 | $3.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.45 Typical High $2.63 | Professional | 56 · Pre-op care only | $2.45 | $2.45 | $2.63 |
Where Virginia sits
The same service costs 1.9 times more in Wyoming than in Arizona. 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· 45th of 51
$25.12
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.