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 $12.88 Median $19.50 Typical High $41.69 | Facility | None | $12.88 | $19.50 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $12.88 Median $15.49 Typical High $37.15 | Professional | None | $12.88 | $15.49 | $37.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $33.88 | Facility | None | $32.36 | $32.36 | $33.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $20.89 | Professional | None | $18.20 | $18.20 | $20.89 |
CareFirst Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $21.88 | Professional | None | $16.98 | $16.98 | $21.88 |
Cigna Setting Facility Modifier None Typical Low $22.39 Median $22.39 Typical High $31.62 | Facility | None | $22.39 | $22.39 | $31.62 |
Cigna Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $22.39 | Professional | None | $16.22 | $16.22 | $22.39 |
Kaiser Permanente Setting Professional Modifier None Typical Low $22.39 Median $32.36 Typical High $41.69 | Professional | None | $22.39 | $32.36 | $41.69 |
Medcost Setting Professional Modifier None Typical Low $19.05 Median $20.89 Typical High $29.51 | Professional | None | $19.05 | $20.89 | $29.51 |
Medcost Setting Facility Modifier None Typical Low $10.47 Median $17.38 Typical High $20.89 | Facility | None | $10.47 | $17.38 | $20.89 |
Medcost Setting Professional Modifier None Typical Low $13.49 Median $17.78 Typical High $39.81 | Professional | None | $13.49 | $17.78 | $39.81 |
Sentara Setting Facility Modifier None Typical Low $15.49 Median $22.39 Typical High $69.18 | Facility | None | $15.49 | $22.39 | $69.18 |
Sentara Setting Professional Modifier None Typical Low $17.38 Median $23.44 Typical High $48.98 | Professional | None | $17.38 | $23.44 | $48.98 |
United Setting Facility Modifier None Typical Low $19.95 Median $28.18 Typical High $40.74 | Facility | None | $19.95 | $28.18 | $40.74 |
United Setting Professional Modifier None Typical Low $14.13 Median $15.85 Typical High $23.44 | Professional | None | $14.13 | $15.85 | $23.44 |
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 $6.46 Median $7.76 Typical High $7.76 | Professional | 52 · Reduced service | $6.46 | $7.76 | $7.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.57 Median $3.09 Typical High $3.09 | Professional | 53 · Discontinued | $2.57 | $3.09 | $3.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.95 Median $2.34 Typical High $2.34 | Professional | 55 · Aftercare only | $1.95 | $2.34 | $2.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.29 Median $1.55 Typical High $1.55 | Professional | 56 · Pre-op care only | $1.29 | $1.55 | $1.55 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.86 Median $1.86 Typical High $2.34 | Professional | RR · Rental | $1.86 | $1.86 | $2.34 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $13.49 Median $14.13 Typical High $14.13 | Professional | UE · Used equipment | $13.49 | $14.13 | $14.13 |
Where Virginia sits
The same service costs 3.7 times more in Hawaii than in Florida. 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· 35th of 51
$18.20
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.