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 $20.89 Median $20.89 Typical High $21.88 | Facility | None | $20.89 | $20.89 | $21.88 |
Aetna Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $21.88 | Professional | None | $20.89 | $20.89 | $21.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $29.51 Median $51.29 Typical High $75.86 | Facility | None | $29.51 | $51.29 | $75.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
CareFirst Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | None | $29.51 | $29.51 | $29.51 |
Cigna Setting Facility Modifier None Typical Low $30.90 Median $42.66 Typical High $54.95 | Facility | None | $30.90 | $42.66 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $17.78 Median $20.89 Typical High $95.50 | Professional | None | $17.78 | $20.89 | $95.50 |
Medcost Setting Facility Modifier None Typical Low $29.51 Median $29.51 Typical High $33.88 | Facility | None | $29.51 | $29.51 | $33.88 |
Medcost Setting Professional Modifier None Typical Low $29.51 Median $58.88 Typical High $107.15 | Professional | None | $29.51 | $58.88 | $107.15 |
Sentara Setting Facility Modifier None Typical Low $21.38 Median $93.33 Typical High $100.00 | Facility | None | $21.38 | $93.33 | $100.00 |
Sentara Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $100.00 | Professional | None | $20.89 | $20.89 | $100.00 |
United Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Facility | None | $20.89 | $20.89 | $20.89 |
United Setting Professional Modifier None Typical Low $29.51 Median $31.62 Typical High $33.11 | Professional | None | $29.51 | $31.62 | $33.11 |
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 $10.47 Median $10.47 Typical High $10.96 | Professional | 52 · Reduced service | $10.47 | $10.47 | $10.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.17 Typical High $4.37 | Professional | 53 · Discontinued | $4.17 | $4.17 | $4.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.16 Typical High $3.31 | Professional | 55 · Aftercare only | $3.16 | $3.16 | $3.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.09 Typical High $2.19 | Professional | 56 · Pre-op care only | $2.09 | $2.09 | $2.19 |
Where Virginia sits
The same service costs 3.8 times more in Wyoming than in Kentucky. 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· 47th of 51
$20.89
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.