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 $25.70 Median $25.70 Typical High $28.18 | Facility | None | $25.70 | $25.70 | $28.18 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $28.18 | Professional | None | $25.70 | $25.70 | $28.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
CareFirst Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | None | $23.99 | $23.99 | $23.99 |
Cigna Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None | $17.38 | $17.38 | $17.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $36.31 Median $46.77 Typical High $67.61 | Professional | None | $36.31 | $46.77 | $67.61 |
Medcost Setting Facility Modifier None Typical Low $25.70 Median $41.69 Typical High $61.66 | Facility | None | $25.70 | $41.69 | $61.66 |
Medcost Setting Professional Modifier None Typical Low $15.14 Median $22.91 Typical High $27.54 | Professional | None | $15.14 | $22.91 | $27.54 |
Sentara Setting Facility Modifier None Typical Low $32.36 Median $57.54 Typical High $10,232.93 | Facility | None | $32.36 | $57.54 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $24.55 Median $38.02 Typical High $67.61 | Professional | None | $24.55 | $38.02 | $67.61 |
United Setting Professional Modifier None Typical Low $18.20 Median $20.89 Typical High $30.20 | Professional | None | $18.20 | $20.89 | $30.20 |
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 $12.88 Median $12.88 Typical High $14.13 | Professional | 52 · Reduced service | $12.88 | $12.88 | $14.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $5.13 Typical High $5.62 | Professional | 53 · Discontinued | $5.13 | $5.13 | $5.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.50 Median $19.50 Typical High $21.38 | Professional | 54 · Surgery only | $19.50 | $19.50 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $3.89 Typical High $4.27 | Professional | 55 · Aftercare only | $3.89 | $3.89 | $4.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $2.57 Typical High $2.82 | Professional | 56 · Pre-op care only | $2.57 | $2.57 | $2.82 |
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
$28.18
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.