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 $26.92 Median $26.92 Typical High $29.51 | Facility | None | $26.92 | $26.92 | $29.51 |
Aetna Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $29.51 | Professional | None | $26.92 | $26.92 | $29.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
CareFirst Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | None | $18.20 | $18.20 | $18.20 |
Kaiser Permanente Setting Professional Modifier None Typical Low $38.02 Median $48.98 Typical High $72.44 | Professional | None | $38.02 | $48.98 | $72.44 |
Medcost Setting Facility Modifier None Typical Low $26.92 Median $60.26 Typical High $64.57 | Facility | None | $26.92 | $60.26 | $64.57 |
Medcost Setting Professional Modifier None Typical Low $17.78 Median $23.99 Typical High $29.51 | Professional | None | $17.78 | $23.99 | $29.51 |
Sentara Setting Facility Modifier None Typical Low $33.88 Median $69.18 Typical High $10,232.93 | Facility | None | $33.88 | $69.18 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $25.70 Median $50.12 Typical High $85.11 | Professional | None | $25.70 | $50.12 | $85.11 |
United Setting Professional Modifier None Typical Low $19.05 Median $21.88 Typical High $31.62 | Professional | None | $19.05 | $21.88 | $31.62 |
5 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 $13.49 Median $13.49 Typical High $14.79 | Professional | 52 · Reduced service | $13.49 | $13.49 | $14.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.37 Median $5.37 Typical High $5.89 | Professional | 53 · Discontinued | $5.37 | $5.37 | $5.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $20.42 Median $20.42 Typical High $22.39 | Professional | 54 · Surgery only | $20.42 | $20.42 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $4.07 Typical High $4.47 | Professional | 55 · Aftercare only | $4.07 | $4.07 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $2.69 Typical High $2.95 | Professional | 56 · Pre-op care only | $2.69 | $2.69 | $2.95 |
Where Virginia sits
The same service costs 2.7 times more in Hawaii than in New York. 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· 25th of 51
$29.51
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.