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 $67.61 Median $70.79 Typical High $125.89 | Facility | None | $67.61 | $70.79 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $69.18 Typical High $93.33 | Professional | None | $67.61 | $69.18 | $93.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $79.43 Median $144.54 Typical High $218.78 | Facility | None | $79.43 | $144.54 | $218.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $57.54 Median $67.61 Typical High $67.61 | Professional | None | $57.54 | $67.61 | $67.61 |
CareFirst Setting Professional Modifier None Typical Low $79.43 Median $97.72 Typical High $97.72 | Professional | None | $79.43 | $97.72 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $134.90 Typical High $169.82 | Facility | None | $89.13 | $134.90 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
Kaiser Permanente Setting Professional Modifier None Typical Low $57.54 Median $70.79 Typical High $316.23 | Professional | None | $57.54 | $70.79 | $316.23 |
Medcost Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $588.84 | Facility | None | $79.43 | $79.43 | $588.84 |
Sentara Setting Facility Modifier None Typical Low $69.18 Median $186.21 Typical High $199.53 | Facility | None | $69.18 | $186.21 | $199.53 |
Sentara Setting Professional Modifier None Typical Low $69.18 Median $186.21 Typical High $199.53 | Professional | None | $69.18 | $186.21 | $199.53 |
United Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
United Setting Professional Modifier None Typical Low $79.43 Median $85.11 Typical High $102.33 | Professional | None | $79.43 | $85.11 | $102.33 |
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 $33.88 Median $33.88 Typical High $35.48 | Professional | 52 · Reduced service | $33.88 | $33.88 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $14.13 | Professional | 53 · Discontinued | $13.49 | $13.49 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.23 Typical High $10.47 | Professional | 55 · Aftercare only | $10.00 | $10.23 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $7.08 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $7.08 |
Where Virginia sits
The same service costs 2.7 times more in South Carolina than in Georgia. 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· 42nd of 51
$79.43
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.