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 $70.79 Typical High $100.00 | Facility | None | $52.48 | $70.79 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $69.18 Typical High $75.86 | Professional | None | $52.48 | $69.18 | $75.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $52.48 Median $109.65 Typical High $173.78 | Facility | None | $52.48 | $109.65 | $173.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $44.67 Median $52.48 Typical High $52.48 | Professional | None | $44.67 | $52.48 | $52.48 |
CareFirst Setting Professional Modifier None Typical Low $44.67 Median $50.12 Typical High $50.12 | Professional | None | $44.67 | $50.12 | $50.12 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $83.18 Typical High $120.23 | Facility | None | $50.12 | $83.18 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $44.67 Median $56.23 Typical High $77.62 | Professional | None | $44.67 | $56.23 | $77.62 |
Medcost Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | None | $69.18 | $69.18 | $69.18 |
Medcost Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $93.33 | Facility | None | $77.62 | $77.62 | $93.33 |
Sentara Setting Facility Modifier None Typical Low $44.67 Median $53.70 Typical High $69.18 | Facility | None | $44.67 | $53.70 | $69.18 |
Sentara Setting Professional Modifier None Typical Low $44.67 Median $53.70 Typical High $69.18 | Professional | None | $44.67 | $53.70 | $69.18 |
United Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
United Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $56.23 | Professional | None | $52.48 | $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 $26.30 Median $26.92 Typical High $28.18 | Professional | 52 · Reduced service | $26.30 | $26.92 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.72 Typical High $11.22 | Professional | 53 · Discontinued | $10.72 | $10.72 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $7.94 Typical High $8.32 | Professional | 55 · Aftercare only | $7.94 | $7.94 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.37 Typical High $5.62 | Professional | 56 · Pre-op care only | $5.37 | $5.37 | $5.62 |
Where Virginia sits
The same service costs 1.7 times more in Arizona than in Rhode Island. 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· 37th 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.