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 $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $8.91 Median $19.50 Typical High $30.20 | Facility | None | $8.91 | $19.50 | $30.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
CareFirst Setting Professional Modifier None Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | None | $8.91 | $8.91 | $8.91 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $104.71 Typical High $131.83 | Facility | None | $54.95 | $104.71 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $61.66 Median $123.03 Typical High $134.90 | Professional | None | $61.66 | $123.03 | $134.90 |
Medcost Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $33.88 | Professional | None | $9.77 | $9.77 | $33.88 |
Medcost Setting Facility Modifier None Typical Low $29.51 Median $46.77 Typical High $46.77 | Facility | None | $29.51 | $46.77 | $46.77 |
Medcost Setting Professional Modifier None Typical Low $4.79 Median $58.88 Typical High $131.83 | Professional | None | $4.79 | $58.88 | $131.83 |
Sentara Setting Facility Modifier None Typical Low $48.98 Median $51.29 Typical High $64.57 | Facility | None | $48.98 | $51.29 | $64.57 |
Sentara Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $51.29 | Professional | None | $50.12 | $50.12 | $51.29 |
United Setting Professional Modifier None Typical Low $50.12 Median $52.48 Typical High $56.23 | Professional | None | $50.12 | $52.48 | $56.23 |
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 $25.70 Median $25.70 Typical High $25.70 | Professional | 52 · Reduced service | $25.70 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | 53 · Discontinued | $10.47 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $7.76 Typical High $7.76 | Professional | 55 · Aftercare only | $7.76 | $7.76 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | 56 · Pre-op care only | $5.25 | $5.25 | $5.25 |
Where Virginia sits
The same service costs 6.6 times more in Alaska than in Hawaii. 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· 20th of 51
$52.48
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.