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 $40.74 Median $40.74 Typical High $44.67 | Facility | None | $40.74 | $40.74 | $44.67 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $40.74 Typical High $44.67 | Professional | None | $36.31 | $40.74 | $44.67 |
Anthem BCBS Setting Professional Modifier None Typical Low $35.48 Median $47.86 Typical High $70.79 | Professional | None | $35.48 | $47.86 | $70.79 |
CareFirst Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $45.71 | Professional | None | $40.74 | $40.74 | $45.71 |
Cigna Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $48.98 | Facility | None | $39.81 | $39.81 | $48.98 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $39.81 | Professional | None | $33.88 | $33.88 | $39.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $46.77 Median $67.61 Typical High $87.10 | Professional | None | $46.77 | $67.61 | $87.10 |
Medcost Setting Professional Modifier None Typical Low $42.66 Median $46.77 Typical High $66.07 | Professional | None | $42.66 | $46.77 | $66.07 |
Medcost Setting Facility Modifier None Typical Low $19.95 Median $36.31 Typical High $46.77 | Facility | None | $19.95 | $36.31 | $46.77 |
Medcost Setting Professional Modifier None Typical Low $36.31 Median $40.74 Typical High $43.65 | Professional | None | $36.31 | $40.74 | $43.65 |
Sentara Setting Facility Modifier None Typical Low $33.88 Median $48.98 Typical High $144.54 | Facility | None | $33.88 | $48.98 | $144.54 |
Sentara Setting Professional Modifier None Typical Low $43.65 Median $52.48 Typical High $102.33 | Professional | None | $43.65 | $52.48 | $102.33 |
United Setting Professional Modifier None Typical Low $29.51 Median $33.11 Typical High $48.98 | Professional | None | $29.51 | $33.11 | $48.98 |
6 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 $20.42 Median $20.42 Typical High $22.39 | Professional | 52 · Reduced service | $20.42 | $20.42 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.13 Typical High $8.91 | Professional | 53 · Discontinued | $8.13 | $8.13 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.03 Typical High $6.61 | Professional | 55 · Aftercare only | $6.03 | $6.03 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.07 Typical High $4.47 | Professional | 56 · Pre-op care only | $4.07 | $4.07 | $4.47 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.17 Median $4.17 Typical High $4.68 | Professional | RR · Rental | $4.17 | $4.17 | $4.68 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $31.62 Median $31.62 Typical High $33.88 | Professional | UE · Used equipment | $31.62 | $31.62 | $33.88 |
Where Virginia sits
The same service costs 2.3 times more in Kansas than in New Jersey. 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
$40.74
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.