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 $28.84 Median $30.20 Typical High $70.79 | Facility | None | $28.84 | $30.20 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $30.20 | Professional | None | $28.84 | $28.84 | $30.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $28.84 Median $63.10 Typical High $97.72 | Facility | None | $28.84 | $63.10 | $97.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
CareFirst Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
Cigna Setting Facility Modifier None Typical Low $41.69 Median $58.88 Typical High $74.13 | Facility | None | $41.69 | $58.88 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $24.55 Median $28.84 Typical High $70.79 | Professional | None | $24.55 | $28.84 | $70.79 |
Medcost Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $97.72 | Professional | None | $23.99 | $23.99 | $97.72 |
Medcost Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $83.18 | Facility | None | $69.18 | $69.18 | $83.18 |
Medcost Setting Professional Modifier None Typical Low $16.98 Median $85.11 Typical High $89.13 | Professional | None | $16.98 | $85.11 | $89.13 |
Sentara Setting Facility Modifier None Typical Low $29.51 Median $70.79 Typical High $75.86 | Facility | None | $29.51 | $70.79 | $75.86 |
Sentara Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $75.86 | Professional | None | $28.84 | $28.84 | $75.86 |
United Setting Professional Modifier None Typical Low $24.55 Median $26.30 Typical High $27.54 | Professional | None | $24.55 | $26.30 | $27.54 |
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 $14.45 Median $14.45 Typical High $15.14 | Professional | 52 · Reduced service | $14.45 | $14.45 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $5.75 Typical High $6.03 | Professional | 53 · Discontinued | $5.75 | $5.75 | $6.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.37 Typical High $4.57 | Professional | 55 · Aftercare only | $4.37 | $4.37 | $4.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $2.88 Typical High $3.02 | Professional | 56 · Pre-op care only | $2.88 | $2.88 | $3.02 |
Where Virginia sits
The same service costs 2.8 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· 13th of 51
$28.84
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.