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 $91.20 Median $91.20 Typical High $100.00 | Facility | None | $91.20 | $91.20 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $100.00 | Professional | None | $91.20 | $91.20 | $100.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
CareFirst Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $165.96 Typical High $239.88 | Professional | None | $128.82 | $165.96 | $239.88 |
Medcost Setting Facility Modifier None Typical Low $91.20 Median $199.53 Typical High $218.78 | Facility | None | $91.20 | $199.53 | $218.78 |
Medcost Setting Professional Modifier None Typical Low $25.70 Median $81.28 Typical High $97.72 | Professional | None | $25.70 | $81.28 | $97.72 |
Sentara Setting Facility Modifier None Typical Low $112.20 Median $229.09 Typical High $10,232.93 | Facility | None | $112.20 | $229.09 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $87.10 Median $165.96 Typical High $281.84 | Professional | None | $87.10 | $165.96 | $281.84 |
United Setting Professional Modifier None Typical Low $63.10 Median $74.13 Typical High $107.15 | Professional | None | $63.10 | $74.13 | $107.15 |
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 $45.71 Median $45.71 Typical High $50.12 | Professional | 52 · Reduced service | $45.71 | $45.71 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $18.20 Typical High $19.95 | Professional | 53 · Discontinued | $18.20 | $18.20 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $67.61 Typical High $74.13 | Professional | 54 · Surgery only | $67.61 | $67.61 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $13.80 Typical High $14.79 | Professional | 55 · Aftercare only | $13.80 | $13.80 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $10.00 | Professional | 56 · Pre-op care only | $9.12 | $9.12 | $10.00 |
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
$100
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.