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 $10.47 Median $10.47 Typical High $11.48 | Facility | None | $10.47 | $10.47 | $11.48 |
Aetna Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $11.48 | Professional | None | $10.47 | $10.47 | $11.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | None | $16.60 | $16.60 | $16.60 |
CareFirst Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | None | $9.55 | $9.55 | $9.55 |
Cigna Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | None | $7.08 | $7.08 | $7.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $14.45 Median $19.05 Typical High $27.54 | Professional | None | $14.45 | $19.05 | $27.54 |
Medcost Setting Facility Modifier None Typical Low $10.47 Median $19.50 Typical High $25.12 | Facility | None | $10.47 | $19.50 | $25.12 |
Medcost Setting Professional Modifier None Typical Low $9.12 Median $9.12 Typical High $12.88 | Professional | None | $9.12 | $9.12 | $12.88 |
Sentara Setting Facility Modifier None Typical Low $12.88 Median $26.30 Typical High $10,232.93 | Facility | None | $12.88 | $26.30 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $9.77 Median $16.98 Typical High $29.51 | Professional | None | $9.77 | $16.98 | $29.51 |
United Setting Professional Modifier None Typical Low $7.24 Median $8.32 Typical High $12.02 | Professional | None | $7.24 | $8.32 | $12.02 |
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 $5.25 Median $5.25 Typical High $5.75 | Professional | 52 · Reduced service | $5.25 | $5.25 | $5.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.09 Median $2.09 Typical High $2.29 | Professional | 53 · Discontinued | $2.09 | $2.09 | $2.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $7.76 Median $7.76 Typical High $8.51 | Professional | 54 · Surgery only | $7.76 | $7.76 | $8.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.55 Median $1.55 Typical High $1.70 | Professional | 55 · Aftercare only | $1.55 | $1.55 | $1.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.05 Median $1.05 Typical High $1.12 | Professional | 56 · Pre-op care only | $1.05 | $1.05 | $1.12 |
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
$11.48
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.