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 $28.84 Median $28.84 Typical High $31.62 | Facility | None | $28.84 | $28.84 | $31.62 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $31.62 | Professional | None | $28.84 | $28.84 | $31.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
CareFirst Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | None | $26.92 | $26.92 | $26.92 |
Cigna Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | None | $19.50 | $19.50 | $19.50 |
Kaiser Permanente Setting Professional Modifier None Typical Low $40.74 Median $52.48 Typical High $77.62 | Professional | None | $40.74 | $52.48 | $77.62 |
Medcost Setting Facility Modifier None Typical Low $28.84 Median $69.18 Typical High $93.33 | Facility | None | $28.84 | $69.18 | $93.33 |
Medcost Setting Professional Modifier None Typical Low $23.99 Median $25.70 Typical High $31.62 | Professional | None | $23.99 | $25.70 | $31.62 |
Sentara Setting Facility Modifier None Typical Low $36.31 Median $87.10 Typical High $10,232.93 | Facility | None | $36.31 | $87.10 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $27.54 Median $74.13 Typical High $131.83 | Professional | None | $27.54 | $74.13 | $131.83 |
United Setting Professional Modifier None Typical Low $20.42 Median $23.44 Typical High $33.88 | Professional | None | $20.42 | $23.44 | $33.88 |
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 $14.45 Median $14.45 Typical High $15.85 | Professional | 52 · Reduced service | $14.45 | $14.45 | $15.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $5.89 Typical High $6.31 | Professional | 53 · Discontinued | $5.89 | $5.89 | $6.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $21.88 Median $21.88 Typical High $23.99 | Professional | 54 · Surgery only | $21.88 | $21.88 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.37 Typical High $4.79 | Professional | 55 · Aftercare only | $4.37 | $4.37 | $4.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $2.95 Typical High $3.16 | Professional | 56 · Pre-op care only | $2.95 | $2.95 | $3.16 |
Where Virginia sits
The same service costs 3.2 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· 24th of 51
$31.62
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.