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 $60.26 Median $63.10 Typical High $112.20 | Facility | None | $60.26 | $63.10 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $61.66 Typical High $63.10 | Professional | None | $60.26 | $61.66 | $63.10 |
Anthem BCBS Setting Facility Modifier None Typical Low $56.23 Median $123.03 Typical High $199.53 | Facility | None | $56.23 | $123.03 | $199.53 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
CareFirst Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | None | $57.54 | $57.54 | $57.54 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $123.03 Typical High $151.36 | Facility | None | $87.10 | $123.03 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $51.29 Median $60.26 Typical High $97.72 | Professional | None | $51.29 | $60.26 | $97.72 |
Medcost Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $162.18 | Facility | None | $56.23 | $56.23 | $162.18 |
Medcost Setting Professional Modifier None Typical Low $91.20 Median $95.50 Typical High $102.33 | Professional | None | $91.20 | $95.50 | $102.33 |
Sentara Setting Facility Modifier None Typical Low $61.66 Median $97.72 Typical High $102.33 | Facility | None | $61.66 | $97.72 | $102.33 |
Sentara Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $102.33 | Professional | None | $60.26 | $60.26 | $102.33 |
United Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
United Setting Professional Modifier None Typical Low $56.23 Median $60.26 Typical High $63.10 | Professional | None | $56.23 | $60.26 | $63.10 |
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 $30.20 Median $30.20 Typical High $31.62 | Professional | 52 · Reduced service | $30.20 | $30.20 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $12.59 | Professional | 53 · Discontinued | $12.02 | $12.02 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.12 Typical High $9.55 | Professional | 55 · Aftercare only | $9.12 | $9.12 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $6.31 | Professional | 56 · Pre-op care only | $6.03 | $6.03 | $6.31 |
Where Virginia sits
The same service costs 2.0 times more in Wyoming than in Hawaii. 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· 41st of 51
$60.26
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.