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 $9.33 Median $10.23 Typical High $11.75 | Facility | None | $9.33 | $10.23 | $11.75 |
Aetna Setting Professional Modifier None Typical Low $9.33 Median $10.00 Typical High $12.59 | Professional | None | $9.33 | $10.00 | $12.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | None | $14.79 | $14.79 | $14.79 |
CareFirst Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | None | $8.71 | $8.71 | $8.71 |
Cigna Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | None | $6.31 | $6.31 | $6.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $13.18 Median $16.98 Typical High $24.55 | Professional | None | $13.18 | $16.98 | $24.55 |
Medcost Setting Facility Modifier None Typical Low $9.33 Median $22.39 Typical High $44.67 | Facility | None | $9.33 | $22.39 | $44.67 |
Medcost Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $10.00 | Professional | None | $8.32 | $8.32 | $10.00 |
Sentara Setting Facility Modifier None Typical Low $13.80 Median $30.20 Typical High $10,232.93 | Facility | None | $13.80 | $30.20 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $8.91 Median $33.11 Typical High $63.10 | Professional | None | $8.91 | $33.11 | $63.10 |
United Setting Professional Modifier None Typical Low $6.61 Median $7.59 Typical High $10.96 | Professional | None | $6.61 | $7.59 | $10.96 |
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 $4.68 Median $4.68 Typical High $5.13 | Professional | 52 · Reduced service | $4.68 | $4.68 | $5.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.86 Median $1.86 Typical High $2.04 | Professional | 53 · Discontinued | $1.86 | $1.86 | $2.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $7.08 Median $7.08 Typical High $7.76 | Professional | 54 · Surgery only | $7.08 | $7.08 | $7.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.41 Median $1.41 Typical High $1.55 | Professional | 55 · Aftercare only | $1.41 | $1.41 | $1.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.93 Median $0.93 Typical High $1.02 | Professional | 56 · Pre-op care only | $0.93 | $0.93 | $1.02 |
Where Virginia sits
The same service costs 4.5 times more in Rhode Island 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· 27th of 51
$10.23
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.