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 $31.62 Median $34.67 Typical High $39.81 | Facility | None | $31.62 | $34.67 | $39.81 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $34.67 Typical High $41.69 | Professional | None | $31.62 | $34.67 | $41.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
CareFirst Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | None | $29.51 | $29.51 | $29.51 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $44.67 Median $57.54 Typical High $83.18 | Professional | None | $44.67 | $57.54 | $83.18 |
Medcost Setting Facility Modifier None Typical Low $31.62 Median $75.86 Typical High $112.20 | Facility | None | $31.62 | $75.86 | $112.20 |
Medcost Setting Professional Modifier None Typical Low $10.00 Median $28.18 Typical High $33.88 | Professional | None | $10.00 | $28.18 | $33.88 |
Sentara Setting Facility Modifier None Typical Low $42.66 Median $97.72 Typical High $10,232.93 | Facility | None | $42.66 | $97.72 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $30.20 Median $89.13 Typical High $158.49 | Professional | None | $30.20 | $89.13 | $158.49 |
United Setting Professional Modifier None Typical Low $22.39 Median $25.70 Typical High $37.15 | Professional | None | $22.39 | $25.70 | $37.15 |
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 $15.85 Median $15.85 Typical High $17.38 | Professional | 52 · Reduced service | $15.85 | $15.85 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.31 Typical High $6.92 | Professional | 53 · Discontinued | $6.31 | $6.31 | $6.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $23.99 Median $23.99 Typical High $26.30 | Professional | 54 · Surgery only | $23.99 | $23.99 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $4.79 Typical High $5.25 | Professional | 55 · Aftercare only | $4.79 | $4.79 | $5.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.16 Typical High $3.47 | Professional | 56 · Pre-op care only | $3.16 | $3.16 | $3.47 |
Where Virginia sits
The same service costs 2.6 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· 27th of 51
$34.67
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.