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 $45.71 Median $45.71 Typical High $50.12 | Facility | None | $45.71 | $45.71 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $50.12 | Professional | None | $45.71 | $45.71 | $50.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
CareFirst Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $64.57 Median $83.18 Typical High $120.23 | Professional | None | $64.57 | $83.18 | $120.23 |
Medcost Setting Facility Modifier None Typical Low $45.71 Median $100.00 Typical High $109.65 | Facility | None | $45.71 | $100.00 | $109.65 |
Medcost Setting Professional Modifier None Typical Low $25.70 Median $40.74 Typical High $48.98 | Professional | None | $25.70 | $40.74 | $48.98 |
Sentara Setting Facility Modifier None Typical Low $56.23 Median $114.82 Typical High $10,232.93 | Facility | None | $56.23 | $114.82 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $43.65 Median $83.18 Typical High $141.25 | Professional | None | $43.65 | $83.18 | $141.25 |
United Setting Professional Modifier None Typical Low $31.62 Median $37.15 Typical High $53.70 | Professional | None | $31.62 | $37.15 | $53.70 |
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 $22.91 Median $22.91 Typical High $25.12 | Professional | 52 · Reduced service | $22.91 | $22.91 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $9.12 Typical High $10.00 | Professional | 53 · Discontinued | $9.12 | $9.12 | $10.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $33.88 Typical High $37.15 | Professional | 54 · Surgery only | $33.88 | $33.88 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $6.92 Typical High $7.41 | Professional | 55 · Aftercare only | $6.92 | $6.92 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.57 Typical High $5.01 | Professional | 56 · Pre-op care only | $4.57 | $4.57 | $5.01 |
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
$50.12
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.