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 $26.30 Median $26.30 Typical High $28.84 | Facility | None | $26.30 | $26.30 | $28.84 |
Aetna Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $28.84 | Professional | None | $26.30 | $26.30 | $28.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
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 $17.78 Median $17.78 Typical High $17.78 | Professional | None | $17.78 | $17.78 | $17.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $37.15 Median $47.86 Typical High $69.18 | Professional | None | $37.15 | $47.86 | $69.18 |
Medcost Setting Facility Modifier None Typical Low $26.30 Median $63.10 Typical High $64.57 | Facility | None | $26.30 | $63.10 | $64.57 |
Medcost Setting Professional Modifier None Typical Low $15.14 Median $23.44 Typical High $28.18 | Professional | None | $15.14 | $23.44 | $28.18 |
Sentara Setting Facility Modifier None Typical Low $32.36 Median $67.61 Typical High $10,232.93 | Facility | None | $32.36 | $67.61 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $25.12 Median $53.70 Typical High $93.33 | Professional | None | $25.12 | $53.70 | $93.33 |
United Setting Professional Modifier None Typical Low $18.62 Median $21.38 Typical High $30.90 | Professional | None | $18.62 | $21.38 | $30.90 |
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 $13.18 Median $13.18 Typical High $14.45 | Professional | 52 · Reduced service | $13.18 | $13.18 | $14.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $5.25 Typical High $5.75 | Professional | 53 · Discontinued | $5.25 | $5.25 | $5.75 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.95 Median $19.95 Typical High $21.38 | Professional | 54 · Surgery only | $19.95 | $19.95 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $3.98 Typical High $4.37 | Professional | 55 · Aftercare only | $3.98 | $3.98 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $2.63 Typical High $2.88 | Professional | 56 · Pre-op care only | $2.63 | $2.63 | $2.88 |
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· 26th of 51
$28.84
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.