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 $38.02 Median $38.02 Typical High $39.81 | Facility | None | $38.02 | $38.02 | $39.81 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $39.81 | Professional | None | $38.02 | $38.02 | $39.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
CareFirst Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $77.62 Typical High $100.00 | Facility | None | $56.23 | $77.62 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $32.36 Median $38.02 Typical High $147.91 | Professional | None | $32.36 | $38.02 | $147.91 |
Medcost Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
Medcost Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $58.88 | Facility | None | $39.81 | $39.81 | $58.88 |
Medcost Setting Professional Modifier None Typical Low $58.88 Median $269.15 Typical High $269.15 | Professional | None | $58.88 | $269.15 | $269.15 |
Sentara Setting Facility Modifier None Typical Low $38.90 Median $54.95 Typical High $58.88 | Facility | None | $38.90 | $54.95 | $58.88 |
Sentara Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $58.88 | Professional | None | $38.02 | $38.02 | $58.88 |
United Setting Professional Modifier None Typical Low $39.81 Median $41.69 Typical High $44.67 | Professional | None | $39.81 | $41.69 | $44.67 |
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 $19.05 Median $19.05 Typical High $19.95 | Professional | 52 · Reduced service | $19.05 | $19.05 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.59 Typical High $7.94 | Professional | 53 · Discontinued | $7.59 | $7.59 | $7.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $5.75 Typical High $6.03 | Professional | 55 · Aftercare only | $5.75 | $5.75 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $3.98 | Professional | 56 · Pre-op care only | $3.80 | $3.80 | $3.98 |
Where Virginia sits
The same service costs 1.6 times more in Alaska than in South Carolina. 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
$38.02
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.