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 $20.89 Median $20.89 Typical High $22.91 | Facility | None | $20.89 | $20.89 | $22.91 |
Aetna Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $22.91 | Professional | None | $20.89 | $20.89 | $22.91 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
CareFirst Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | None | $19.05 | $19.05 | $19.05 |
Cigna Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | None | $14.13 | $14.13 | $14.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $29.51 Median $38.02 Typical High $54.95 | Professional | None | $29.51 | $38.02 | $54.95 |
Medcost Setting Facility Modifier None Typical Low $20.89 Median $39.81 Typical High $50.12 | Facility | None | $20.89 | $39.81 | $50.12 |
Medcost Setting Professional Modifier None Typical Low $12.88 Median $18.62 Typical High $22.39 | Professional | None | $12.88 | $18.62 | $22.39 |
Sentara Setting Facility Modifier None Typical Low $25.70 Median $52.48 Typical High $10,232.93 | Facility | None | $25.70 | $52.48 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $19.95 Median $33.88 Typical High $58.88 | Professional | None | $19.95 | $33.88 | $58.88 |
United Setting Professional Modifier None Typical Low $14.45 Median $16.98 Typical High $24.55 | Professional | None | $14.45 | $16.98 | $24.55 |
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 $10.47 Median $10.47 Typical High $11.48 | Professional | 52 · Reduced service | $10.47 | $10.47 | $11.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.17 Typical High $4.57 | Professional | 53 · Discontinued | $4.17 | $4.17 | $4.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $15.49 Median $15.49 Typical High $16.98 | Professional | 54 · Surgery only | $15.49 | $15.49 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.09 Median $3.09 Typical High $3.39 | Professional | 55 · Aftercare only | $3.09 | $3.09 | $3.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.09 Typical High $2.29 | Professional | 56 · Pre-op care only | $2.09 | $2.09 | $2.29 |
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
$22.91
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.