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 $11.22 Median $11.22 Typical High $12.30 | Facility | None | $11.22 | $11.22 | $12.30 |
Aetna Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $12.30 | Professional | None | $11.22 | $11.22 | $12.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | None | $17.78 | $17.78 | $17.78 |
CareFirst Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | None | $10.23 | $10.23 | $10.23 |
Cigna Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | None | $7.59 | $7.59 | $7.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $15.49 Median $20.42 Typical High $29.51 | Professional | None | $15.49 | $20.42 | $29.51 |
Medcost Setting Facility Modifier None Typical Low $11.22 Median $23.44 Typical High $26.92 | Facility | None | $11.22 | $23.44 | $26.92 |
Medcost Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $12.02 | Professional | None | $9.77 | $9.77 | $12.02 |
Sentara Setting Facility Modifier None Typical Low $13.80 Median $28.18 Typical High $10,232.93 | Facility | None | $13.80 | $28.18 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $10.47 Median $19.50 Typical High $33.88 | Professional | None | $10.47 | $19.50 | $33.88 |
United Setting Professional Modifier None Typical Low $7.76 Median $8.91 Typical High $12.88 | Professional | None | $7.76 | $8.91 | $12.88 |
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 $5.62 Median $5.62 Typical High $6.03 | Professional | 52 · Reduced service | $5.62 | $5.62 | $6.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.24 Median $2.24 Typical High $2.45 | Professional | 53 · Discontinued | $2.24 | $2.24 | $2.45 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $8.32 Median $8.32 Typical High $9.12 | Professional | 54 · Surgery only | $8.32 | $8.32 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.66 Median $1.66 Typical High $1.82 | Professional | 55 · Aftercare only | $1.66 | $1.66 | $1.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.12 Typical High $1.23 | Professional | 56 · Pre-op care only | $1.12 | $1.12 | $1.23 |
Where Virginia sits
The same service costs 2.7 times more in Idaho 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
$12.30
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.