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 $30.20 Median $44.67 Typical High $97.72 | Facility | None | $30.20 | $44.67 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $36.31 Typical High $38.02 | Professional | None | $30.20 | $36.31 | $38.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $79.43 | Facility | None | $75.86 | $75.86 | $79.43 |
Anthem BCBS Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $48.98 | Professional | None | $42.66 | $42.66 | $48.98 |
CareFirst Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $51.29 | Professional | None | $38.90 | $38.90 | $51.29 |
Cigna Setting Facility Modifier None Typical Low $30.90 Median $46.77 Typical High $46.77 | Facility | None | $30.90 | $46.77 | $46.77 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $46.77 | Professional | None | $33.88 | $33.88 | $46.77 |
Kaiser Permanente Setting Professional Modifier None Typical Low $52.48 Median $75.86 Typical High $97.72 | Professional | None | $52.48 | $75.86 | $97.72 |
Medcost Setting Professional Modifier None Typical Low $44.67 Median $48.98 Typical High $69.18 | Professional | None | $44.67 | $48.98 | $69.18 |
Medcost Setting Facility Modifier None Typical Low $25.70 Median $40.74 Typical High $48.98 | Facility | None | $25.70 | $40.74 | $48.98 |
Medcost Setting Professional Modifier None Typical Low $32.36 Median $42.66 Typical High $93.33 | Professional | None | $32.36 | $42.66 | $93.33 |
Sentara Setting Facility Modifier None Typical Low $36.31 Median $51.29 Typical High $162.18 | Facility | None | $36.31 | $51.29 | $162.18 |
Sentara Setting Professional Modifier None Typical Low $40.74 Median $54.95 Typical High $112.20 | Professional | None | $40.74 | $54.95 | $112.20 |
United Setting Facility Modifier None Typical Low $19.05 Median $36.31 Typical High $97.72 | Facility | None | $19.05 | $36.31 | $97.72 |
United Setting Professional Modifier None Typical Low $33.11 Median $37.15 Typical High $54.95 | Professional | None | $33.11 | $37.15 | $54.95 |
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 $15.14 Median $18.20 Typical High $18.62 | Professional | 52 · Reduced service | $15.14 | $18.20 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $7.24 Typical High $7.41 | Professional | 53 · Discontinued | $6.03 | $7.24 | $7.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $5.50 Typical High $5.62 | Professional | 55 · Aftercare only | $4.47 | $5.50 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $3.63 Typical High $3.72 | Professional | 56 · Pre-op care only | $3.02 | $3.63 | $3.72 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.37 Median $4.37 Typical High $5.89 | Professional | RR · Rental | $4.37 | $4.37 | $5.89 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $31.62 Median $32.36 Typical High $32.36 | Professional | UE · Used equipment | $31.62 | $32.36 | $32.36 |
Where Virginia sits
The same service costs 2.9 times more in Kansas than in Delaware. 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· 43rd of 51
$42.66
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.