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 $67.61 Median $67.61 Typical High $72.44 | Facility | None | $67.61 | $67.61 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $72.44 | Professional | None | $67.61 | $67.61 | $72.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $58.88 Median $77.62 Typical High $114.82 | Professional | None | $58.88 | $77.62 | $114.82 |
CareFirst Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $75.86 | Professional | None | $66.07 | $66.07 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
Kaiser Permanente Setting Professional Modifier None Typical Low $77.62 Median $109.65 Typical High $144.54 | Professional | None | $77.62 | $109.65 | $144.54 |
Medcost Setting Professional Modifier None Typical Low $69.18 Median $77.62 Typical High $107.15 | Professional | None | $69.18 | $77.62 | $107.15 |
Medcost Setting Facility Modifier None Typical Low $32.36 Median $58.88 Typical High $77.62 | Facility | None | $32.36 | $58.88 | $77.62 |
Medcost Setting Professional Modifier None Typical Low $58.88 Median $67.61 Typical High $72.44 | Professional | None | $58.88 | $67.61 | $72.44 |
Sentara Setting Facility Modifier None Typical Low $54.95 Median $81.28 Typical High $239.88 | Facility | None | $54.95 | $81.28 | $239.88 |
Sentara Setting Professional Modifier None Typical Low $70.79 Median $85.11 Typical High $165.96 | Professional | None | $70.79 | $85.11 | $165.96 |
United Setting Professional Modifier None Typical Low $48.98 Median $53.70 Typical High $81.28 | Professional | None | $48.98 | $53.70 | $81.28 |
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 $33.11 Median $33.11 Typical High $36.31 | Professional | 52 · Reduced service | $33.11 | $33.11 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $14.45 | Professional | 53 · Discontinued | $13.49 | $13.49 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $10.96 | Professional | 55 · Aftercare only | $10.00 | $10.00 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $7.24 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $7.24 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.92 Median $6.92 Typical High $7.76 | Professional | RR · Rental | $6.92 | $6.92 | $7.76 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $51.29 Median $51.29 Typical High $56.23 | Professional | UE · Used equipment | $51.29 | $51.29 | $56.23 |
Where Virginia sits
The same service costs 2.5 times more in Idaho than in Colorado. 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· 30th of 51
$69.18
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.