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 $70.79 Median $70.79 Typical High $74.13 | Facility | None | $70.79 | $70.79 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $74.13 Typical High $97.72 | Professional | None | $70.79 | $74.13 | $97.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $74.13 Median $147.91 Typical High $229.09 | Facility | None | $74.13 | $147.91 | $229.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
CareFirst Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $141.25 Typical High $181.97 | Facility | None | $102.33 | $141.25 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
Kaiser Permanente Setting Professional Modifier None Typical Low $60.26 Median $70.79 Typical High $112.20 | Professional | None | $60.26 | $70.79 | $112.20 |
Medcost Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $75.86 | Professional | None | $58.88 | $58.88 | $75.86 |
Medcost Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $190.55 | Facility | None | $107.15 | $107.15 | $190.55 |
Medcost Setting Professional Modifier None Typical Low $61.66 Median $89.13 Typical High $107.15 | Professional | None | $61.66 | $89.13 | $107.15 |
Sentara Setting Facility Modifier None Typical Low $72.44 Median $112.20 Typical High $117.49 | Facility | None | $72.44 | $112.20 | $117.49 |
Sentara Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $117.49 | Professional | None | $70.79 | $70.79 | $117.49 |
United Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
United Setting Professional Modifier None Typical Low $74.13 Median $77.62 Typical High $83.18 | Professional | None | $74.13 | $77.62 | $83.18 |
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 $35.48 Median $35.48 Typical High $37.15 | Professional | 52 · Reduced service | $35.48 | $35.48 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.13 Typical High $14.79 | Professional | 53 · Discontinued | $14.13 | $14.13 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.47 Typical High $10.96 | Professional | 55 · Aftercare only | $10.47 | $10.47 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.08 Typical High $7.41 | Professional | 56 · Pre-op care only | $7.08 | $7.08 | $7.41 |
Where Virginia sits
The same service costs 1.5 times more in Wyoming than in Florida. 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
$70.79
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.