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 $3,162.28 Median $3,162.28 Typical High $3,162.28 | Facility | None | $3,162.28 | $3,162.28 | $3,162.28 |
Aetna Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Professional | None | $3,162.28 | $3,162.28 | $3,162.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,951.21 | $2,951.21 | $2,951.21 |
CareFirst Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $239.88 Typical High $331.13 | Facility | None | $190.55 | $239.88 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $125.89 Median $158.49 Typical High $3,311.31 | Professional | None | $125.89 | $158.49 | $3,311.31 |
Medcost Setting Facility Modifier None Typical Low $3,162.28 Median $3,715.35 Typical High $4,786.30 | Facility | None | $3,162.28 | $3,715.35 | $4,786.30 |
Medcost Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $3,715.35 | Professional | None | $109.65 | $109.65 | $3,715.35 |
Sentara Setting Facility Modifier None Typical Low $112.20 Median $181.97 Typical High $10,232.93 | Facility | None | $112.20 | $181.97 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $87.10 Median $151.36 Typical High $275.42 | Professional | None | $87.10 | $151.36 | $275.42 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $134.90 | Professional | None | $125.89 | $125.89 | $134.90 |
4 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 $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | 52 · Reduced service | $1,548.82 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | 53 · Discontinued | $630.96 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | 55 · Aftercare only | $467.74 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | 56 · Pre-op care only | $316.23 | $316.23 | $316.23 |
Where Virginia sits
The same service costs 26.9 times more in Wyoming than in North Carolina. 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· 21st of 51
$525
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.