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 $162.18 Median $169.82 Typical High $407.38 | Facility | None | $162.18 | $169.82 | $407.38 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $169.82 Typical High $346.74 | Professional | None | $162.18 | $169.82 | $346.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $177.83 Median $338.84 Typical High $524.81 | Facility | None | $177.83 | $338.84 | $524.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
CareFirst Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $323.59 Typical High $416.87 | Facility | None | $234.42 | $323.59 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $134.90 Median $162.18 Typical High $1,445.44 | Professional | None | $134.90 | $162.18 | $1,445.44 |
Medcost Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $1,071.52 | Professional | None | $245.47 | $245.47 | $1,071.52 |
Medcost Setting Facility Modifier None Typical Low $407.38 Median $467.74 Typical High $467.74 | Facility | None | $407.38 | $467.74 | $467.74 |
Medcost Setting Professional Modifier None Typical Low $204.17 Median $512.86 Typical High $645.65 | Professional | None | $204.17 | $512.86 | $645.65 |
Sentara Setting Facility Modifier None Typical Low $165.96 Median $446.68 Typical High $478.63 | Facility | None | $165.96 | $446.68 | $478.63 |
Sentara Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $446.68 | Professional | None | $162.18 | $162.18 | $446.68 |
United Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
United Setting Professional Modifier None Typical Low $177.83 Median $186.21 Typical High $199.53 | Professional | None | $177.83 | $186.21 | $199.53 |
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 $79.43 Median $79.43 Typical High $85.11 | Professional | 52 · Reduced service | $79.43 | $79.43 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $32.36 Typical High $33.88 | Professional | 53 · Discontinued | $32.36 | $32.36 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $25.12 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $16.98 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $16.98 |
Where Virginia sits
The same service costs 1.9 times more in Wyoming than in Nevada. 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· 42nd of 51
$162
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.