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 $20.42 Median $20.42 Typical High $22.39 | Facility | None | $20.42 | $20.42 | $22.39 |
Aetna Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $22.39 | Professional | None | $20.42 | $20.42 | $22.39 |
Anthem BCBS Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
CareFirst Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | None | $19.05 | $19.05 | $19.05 |
Cigna Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | None | $13.80 | $13.80 | $13.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $28.84 Median $37.15 Typical High $53.70 | Professional | None | $28.84 | $37.15 | $53.70 |
Medcost Setting Facility Modifier None Typical Low $20.42 Median $48.98 Typical High $51.29 | Facility | None | $20.42 | $48.98 | $51.29 |
Medcost Setting Professional Modifier None Typical Low $8.91 Median $18.20 Typical High $21.88 | Professional | None | $8.91 | $18.20 | $21.88 |
Sentara Setting Facility Modifier None Typical Low $25.70 Median $54.95 Typical High $10,232.93 | Facility | None | $25.70 | $54.95 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $19.50 Median $42.66 Typical High $79.43 | Professional | None | $19.50 | $42.66 | $79.43 |
United Setting Professional Modifier None Typical Low $14.45 Median $16.60 Typical High $23.99 | Professional | None | $14.45 | $16.60 | $23.99 |
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 $10.23 Median $10.23 Typical High $11.22 | Professional | 52 · Reduced service | $10.23 | $10.23 | $11.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $4.07 Typical High $4.47 | Professional | 53 · Discontinued | $4.07 | $4.07 | $4.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $15.49 Median $15.49 Typical High $16.98 | Professional | 54 · Surgery only | $15.49 | $15.49 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.09 Median $3.09 Typical High $3.39 | Professional | 55 · Aftercare only | $3.09 | $3.09 | $3.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.04 Typical High $2.24 | Professional | 56 · Pre-op care only | $2.04 | $2.04 | $2.24 |
Where Virginia sits
The same service costs 2.6 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
$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.