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 $31.62 Median $33.88 Typical High $60.26 | Facility | None | $31.62 | $33.88 | $60.26 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $33.88 Typical High $33.88 | Professional | None | $31.62 | $33.88 | $33.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $35.48 Median $67.61 Typical High $104.71 | Facility | None | $35.48 | $67.61 | $104.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
CareFirst Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
Cigna Setting Facility Modifier None Typical Low $41.69 Median $64.57 Typical High $79.43 | Facility | None | $41.69 | $64.57 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Kaiser Permanente Setting Professional Modifier None Typical Low $26.92 Median $31.62 Typical High $81.28 | Professional | None | $26.92 | $31.62 | $81.28 |
Medcost Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $51.29 | Facility | None | $35.48 | $35.48 | $51.29 |
Medcost Setting Professional Modifier None Typical Low $70.79 Median $95.50 Typical High $100.00 | Professional | None | $70.79 | $95.50 | $100.00 |
Sentara Setting Facility Modifier None Typical Low $33.11 Median $66.07 Typical High $70.79 | Facility | None | $33.11 | $66.07 | $70.79 |
Sentara Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $70.79 | Professional | None | $31.62 | $31.62 | $70.79 |
United Setting Facility Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Facility | None | $31.62 | $31.62 | $31.62 |
United Setting Professional Modifier None Typical Low $35.48 Median $38.02 Typical High $39.81 | Professional | None | $35.48 | $38.02 | $39.81 |
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 $15.85 Median $15.85 Typical High $16.60 | Professional | 52 · Reduced service | $15.85 | $15.85 | $16.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.46 Typical High $6.76 | Professional | 53 · Discontinued | $6.46 | $6.46 | $6.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $4.79 Typical High $5.01 | Professional | 55 · Aftercare only | $4.79 | $4.79 | $5.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.24 Typical High $3.39 | Professional | 56 · Pre-op care only | $3.24 | $3.24 | $3.39 |
Where Virginia sits
The same service costs 1.7 times more in Hawaii 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· 37th of 51
$31.62
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.