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 $15.49 Median $15.49 Typical High $16.98 | Facility | None | $15.49 | $15.49 | $16.98 |
Aetna Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $16.98 | Professional | None | $15.49 | $15.49 | $16.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
CareFirst Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | None | $14.13 | $14.13 | $14.13 |
Cigna Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | None | $10.47 | $10.47 | $10.47 |
Kaiser Permanente Setting Professional Modifier None Typical Low $21.88 Median $28.18 Typical High $40.74 | Professional | None | $21.88 | $28.18 | $40.74 |
Medcost Setting Facility Modifier None Typical Low $15.49 Median $30.20 Typical High $37.15 | Facility | None | $15.49 | $30.20 | $37.15 |
Medcost Setting Professional Modifier None Typical Low $12.02 Median $13.80 Typical High $16.60 | Professional | None | $12.02 | $13.80 | $16.60 |
Sentara Setting Facility Modifier None Typical Low $19.05 Median $38.90 Typical High $10,232.93 | Facility | None | $19.05 | $38.90 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $14.79 Median $25.70 Typical High $45.71 | Professional | None | $14.79 | $25.70 | $45.71 |
United Setting Professional Modifier None Typical Low $10.72 Median $12.59 Typical High $18.20 | Professional | None | $10.72 | $12.59 | $18.20 |
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 $7.76 Median $7.76 Typical High $8.51 | Professional | 52 · Reduced service | $7.76 | $7.76 | $8.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.09 Median $3.09 Typical High $3.39 | Professional | 53 · Discontinued | $3.09 | $3.09 | $3.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $11.48 Median $11.48 Typical High $12.59 | Professional | 54 · Surgery only | $11.48 | $11.48 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.29 Median $2.29 Typical High $2.51 | Professional | 55 · Aftercare only | $2.29 | $2.29 | $2.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.55 Median $1.55 Typical High $1.70 | Professional | 56 · Pre-op care only | $1.55 | $1.55 | $1.70 |
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
$16.98
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.