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 $16.22 Median $16.22 Typical High $16.98 | Facility | None | $16.22 | $16.22 | $16.98 |
Aetna Setting Professional Modifier None Typical Low $16.22 Median $16.98 Typical High $23.99 | Professional | None | $16.22 | $16.98 | $23.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $13.80 Median $32.36 Typical High $48.98 | Facility | None | $13.80 | $32.36 | $48.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $13.80 Median $16.22 Typical High $16.22 | Professional | None | $13.80 | $16.22 | $16.22 |
CareFirst Setting Professional Modifier None Typical Low $15.14 Median $25.12 Typical High $25.12 | Professional | None | $15.14 | $25.12 | $25.12 |
Cigna Setting Facility Modifier None Typical Low $16.98 Median $25.70 Typical High $40.74 | Facility | None | $16.98 | $25.70 | $40.74 |
Cigna Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | None | $16.22 | $16.22 | $16.22 |
Kaiser Permanente Setting Professional Modifier None Typical Low $13.80 Median $16.98 Typical High $85.11 | Professional | None | $13.80 | $16.98 | $85.11 |
Medcost Setting Facility Modifier None Typical Low $13.80 Median $13.80 Typical High $25.70 | Facility | None | $13.80 | $13.80 | $25.70 |
Sentara Setting Facility Modifier None Typical Low $16.60 Median $72.44 Typical High $75.86 | Facility | None | $16.60 | $72.44 | $75.86 |
Sentara Setting Professional Modifier None Typical Low $16.60 Median $72.44 Typical High $75.86 | Professional | None | $16.60 | $72.44 | $75.86 |
United Setting Facility Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Facility | None | $16.22 | $16.22 | $16.22 |
United Setting Professional Modifier None Typical Low $13.80 Median $14.45 Typical High $17.78 | Professional | None | $13.80 | $14.45 | $17.78 |
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 $8.13 Median $8.13 Typical High $8.51 | Professional | 52 · Reduced service | $8.13 | $8.13 | $8.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.24 Median $3.24 Typical High $3.39 | Professional | 53 · Discontinued | $3.24 | $3.24 | $3.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.40 Median $2.45 Typical High $2.51 | Professional | 55 · Aftercare only | $2.40 | $2.45 | $2.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $1.62 Typical High $1.70 | Professional | 56 · Pre-op care only | $1.62 | $1.62 | $1.70 |
Where Virginia sits
The same service costs 5.9 times more in Wyoming than in North Dakota. 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· 40th of 51
$16.22
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.