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 $12.02 Median $12.02 Typical High $13.18 | Facility | None | $12.02 | $12.02 | $13.18 |
Aetna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $13.18 | Professional | None | $12.02 | $12.02 | $13.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | None | $19.05 | $19.05 | $19.05 |
CareFirst Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | None | $11.22 | $11.22 | $11.22 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $16.98 Median $21.88 Typical High $32.36 | Professional | None | $16.98 | $21.88 | $32.36 |
Medcost Setting Facility Modifier None Typical Low $12.02 Median $23.99 Typical High $28.84 | Facility | None | $12.02 | $23.99 | $28.84 |
Medcost Setting Professional Modifier None Typical Low $7.59 Median $10.72 Typical High $13.18 | Professional | None | $7.59 | $10.72 | $13.18 |
Sentara Setting Facility Modifier None Typical Low $15.14 Median $31.62 Typical High $10,232.93 | Facility | None | $15.14 | $31.62 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $11.48 Median $20.42 Typical High $36.31 | Professional | None | $11.48 | $20.42 | $36.31 |
United Setting Professional Modifier None Typical Low $8.51 Median $9.77 Typical High $14.13 | Professional | None | $8.51 | $9.77 | $14.13 |
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 $6.03 Median $6.03 Typical High $6.61 | Professional | 52 · Reduced service | $6.03 | $6.03 | $6.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.45 Median $2.45 Typical High $2.63 | Professional | 53 · Discontinued | $2.45 | $2.45 | $2.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $9.12 Median $9.12 Typical High $10.00 | Professional | 54 · Surgery only | $9.12 | $9.12 | $10.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.82 Median $1.82 Typical High $2.00 | Professional | 55 · Aftercare only | $1.82 | $1.82 | $2.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.23 Median $1.23 Typical High $1.32 | Professional | 56 · Pre-op care only | $1.23 | $1.23 | $1.32 |
Where Virginia sits
The same service costs 2.8 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· 24th of 51
$13.18
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.