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 $389.05 Median $389.05 Typical High $416.87 | Facility | None | $389.05 | $389.05 | $416.87 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $398.11 Typical High $416.87 | Professional | None | $389.05 | $398.11 | $416.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $380.19 Median $794.33 Typical High $1,288.25 | Facility | None | $380.19 | $794.33 | $1,288.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $331.13 Median $389.05 Typical High $389.05 | Professional | None | $331.13 | $389.05 | $389.05 |
CareFirst Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $380.19 | Professional | None | $363.08 | $363.08 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $741.31 Typical High $1,023.29 | Facility | None | $575.44 | $741.31 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
Kaiser Permanente Setting Professional Modifier None Typical Low $331.13 Median $416.87 Typical High $467.74 | Professional | None | $331.13 | $416.87 | $467.74 |
Medcost Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $630.96 | Facility | None | $380.19 | $380.19 | $630.96 |
Sentara Setting Facility Modifier None Typical Low $354.81 Median $389.05 Typical High $512.86 | Facility | None | $354.81 | $389.05 | $512.86 |
Sentara Setting Professional Modifier None Typical Low $354.81 Median $389.05 Typical High $512.86 | Professional | None | $354.81 | $389.05 | $512.86 |
United Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
United Setting Professional Modifier None Typical Low $380.19 Median $407.38 Typical High $446.68 | Professional | None | $380.19 | $407.38 | $446.68 |
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 $194.98 Median $199.53 Typical High $204.17 | Professional | 52 · Reduced service | $194.98 | $199.53 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $79.43 Typical High $83.18 | Professional | 53 · Discontinued | $79.43 | $79.43 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $58.88 Typical High $61.66 | Professional | 55 · Aftercare only | $58.88 | $58.88 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $39.81 Typical High $41.69 | Professional | 56 · Pre-op care only | $38.90 | $39.81 | $41.69 |
Where Virginia sits
The same service costs 1.9 times more in Texas than in Illinois. 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· 41st of 51
$389
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.