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 $22.39 Median $22.39 Typical High $22.39 | Facility | None | $22.39 | $22.39 | $22.39 |
Aetna Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | None | $22.39 | $22.39 | $22.39 |
Anthem BCBS Setting Facility Modifier None Typical Low $23.44 Median $48.98 Typical High $75.86 | Facility | None | $23.44 | $48.98 | $75.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $23.44 | Professional | None | $21.88 | $21.88 | $23.44 |
CareFirst Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | None | $23.44 | $23.44 | $23.44 |
Cigna Setting Facility Modifier None Typical Low $23.44 Median $45.71 Typical High $56.23 | Facility | None | $23.44 | $45.71 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | None | $22.39 | $22.39 | $22.39 |
Kaiser Permanente Setting Professional Modifier None Typical Low $44.67 Median $48.98 Typical High $48.98 | Professional | None | $44.67 | $48.98 | $48.98 |
Medcost Setting Facility Modifier None Typical Low $26.30 Median $26.30 Typical High $34.67 | Facility | None | $26.30 | $26.30 | $34.67 |
Medcost Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $26.30 | Professional | None | $23.99 | $23.99 | $26.30 |
Sentara Setting Facility Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Facility | None | $22.39 | $22.39 | $22.39 |
Sentara Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | None | $22.39 | $22.39 | $22.39 |
United Setting Facility Modifier None Typical Low $23.44 Median $23.44 Typical High $23.44 | Facility | None | $23.44 | $23.44 | $23.44 |
United Setting Professional Modifier None Typical Low $21.88 Median $23.44 Typical High $24.55 | Professional | None | $21.88 | $23.44 | $24.55 |
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 $11.22 Median $11.22 Typical High $11.22 | Professional | 52 · Reduced service | $11.22 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | 53 · Discontinued | $4.47 | $4.47 | $4.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | 55 · Aftercare only | $3.39 | $3.39 | $3.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | 56 · Pre-op care only | $2.24 | $2.24 | $2.24 |
Where Virginia sits
The same service costs 1.5 times more in Alaska 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· 47th of 51
$22.39
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.