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 $26.92 Median $28.18 Typical High $34.67 | Facility | None | $26.92 | $28.18 | $34.67 |
Aetna Setting Professional Modifier None Typical Low $26.92 Median $27.54 Typical High $30.90 | Professional | None | $26.92 | $27.54 | $30.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $26.92 Median $54.95 Typical High $87.10 | Facility | None | $26.92 | $54.95 | $87.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $22.39 Median $26.92 Typical High $26.92 | Professional | None | $22.39 | $26.92 | $26.92 |
CareFirst Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $27.54 | Professional | None | $23.44 | $23.44 | $27.54 |
Cigna Setting Facility Modifier None Typical Low $38.02 Median $48.98 Typical High $66.07 | Facility | None | $38.02 | $48.98 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | None | $26.92 | $26.92 | $26.92 |
Kaiser Permanente Setting Professional Modifier None Typical Low $22.39 Median $28.18 Typical High $91.20 | Professional | None | $22.39 | $28.18 | $91.20 |
Medcost Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $95.50 | Facility | None | $26.92 | $26.92 | $95.50 |
Sentara Setting Facility Modifier None Typical Low $27.54 Median $75.86 Typical High $81.28 | Facility | None | $27.54 | $75.86 | $81.28 |
Sentara Setting Professional Modifier None Typical Low $27.54 Median $75.86 Typical High $81.28 | Professional | None | $27.54 | $75.86 | $81.28 |
United Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Facility | None | $26.92 | $26.92 | $26.92 |
United Setting Professional Modifier None Typical Low $26.30 Median $26.92 Typical High $28.18 | Professional | None | $26.30 | $26.92 | $28.18 |
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 $13.18 Median $13.49 Typical High $14.13 | Professional | 52 · Reduced service | $13.18 | $13.49 | $14.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.37 Median $5.37 Typical High $5.62 | Professional | 53 · Discontinued | $5.37 | $5.37 | $5.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $4.07 Typical High $4.17 | Professional | 55 · Aftercare only | $3.98 | $4.07 | $4.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $2.69 Typical High $2.82 | Professional | 56 · Pre-op care only | $2.63 | $2.69 | $2.82 |
Where Virginia sits
The same service costs 2.9 times more in Wyoming than in Minnesota. 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· 48th of 51
$26.92
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.