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 $29.51 Median $29.51 Typical High $32.36 | Facility | None | $29.51 | $29.51 | $32.36 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $33.11 | Professional | None | $29.51 | $29.51 | $33.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
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 $19.95 Median $19.95 Typical High $19.95 | Professional | None | $19.95 | $19.95 | $19.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $40.74 Median $53.70 Typical High $77.62 | Professional | None | $40.74 | $53.70 | $77.62 |
Medcost Setting Facility Modifier None Typical Low $29.51 Median $48.98 Typical High $70.79 | Facility | None | $29.51 | $48.98 | $70.79 |
Medcost Setting Professional Modifier None Typical Low $15.14 Median $26.30 Typical High $31.62 | Professional | None | $15.14 | $26.30 | $31.62 |
Sentara Setting Facility Modifier None Typical Low $36.31 Median $67.61 Typical High $10,232.93 | Facility | None | $36.31 | $67.61 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $28.18 Median $42.66 Typical High $79.43 | Professional | None | $28.18 | $42.66 | $79.43 |
United Setting Professional Modifier None Typical Low $20.42 Median $23.44 Typical High $34.67 | Professional | None | $20.42 | $23.44 | $34.67 |
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 $14.79 Median $14.79 Typical High $16.22 | Professional | 52 · Reduced service | $14.79 | $14.79 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $5.89 Typical High $6.46 | Professional | 53 · Discontinued | $5.89 | $5.89 | $6.46 |
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 $3.24 | Professional | 56 · Pre-op care only | $2.95 | $2.95 | $3.24 |
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· 23rd of 51
$32.36
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.