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 $15.85 Median $15.85 Typical High $17.38 | Facility | None | $15.85 | $15.85 | $17.38 |
Aetna Setting Professional Modifier None Typical Low $15.85 Median $16.60 Typical High $19.50 | Professional | None | $15.85 | $16.60 | $19.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
CareFirst Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | None | $14.79 | $14.79 | $14.79 |
Cigna Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | None | $10.72 | $10.72 | $10.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $22.39 Median $28.84 Typical High $41.69 | Professional | None | $22.39 | $28.84 | $41.69 |
Medcost Setting Facility Modifier None Typical Low $15.85 Median $38.02 Typical High $56.23 | Facility | None | $15.85 | $38.02 | $56.23 |
Medcost Setting Professional Modifier None Typical Low $10.00 Median $14.13 Typical High $16.98 | Professional | None | $10.00 | $14.13 | $16.98 |
Sentara Setting Facility Modifier None Typical Low $20.89 Median $47.86 Typical High $10,232.93 | Facility | None | $20.89 | $47.86 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $15.14 Median $44.67 Typical High $79.43 | Professional | None | $15.14 | $44.67 | $79.43 |
United Setting Professional Modifier None Typical Low $11.22 Median $12.88 Typical High $18.62 | Professional | None | $11.22 | $12.88 | $18.62 |
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 $7.94 Median $7.94 Typical High $8.71 | Professional | 52 · Reduced service | $7.94 | $7.94 | $8.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.16 Median $3.16 Typical High $3.47 | Professional | 53 · Discontinued | $3.16 | $3.16 | $3.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $12.02 Median $12.02 Typical High $13.18 | Professional | 54 · Surgery only | $12.02 | $12.02 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.40 Median $2.40 Typical High $2.63 | Professional | 55 · Aftercare only | $2.40 | $2.40 | $2.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.58 Median $1.58 Typical High $1.74 | Professional | 56 · Pre-op care only | $1.58 | $1.58 | $1.74 |
Where Virginia sits
The same service costs 3.5 times more in Rhode Island 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· 25th of 51
$17.38
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.