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 $72.44 Median $87.10 Typical High $87.10 | Facility | None | $72.44 | $87.10 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $87.10 Typical High $91.20 | Professional | None | $72.44 | $87.10 | $91.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $190.55 | Facility | None | $181.97 | $181.97 | $190.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $120.23 | Professional | None | $107.15 | $107.15 | $120.23 |
CareFirst Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $123.03 | Professional | None | $95.50 | $95.50 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $123.03 Typical High $123.03 | Facility | None | $81.28 | $123.03 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $123.03 | Professional | None | $89.13 | $89.13 | $123.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $125.89 Median $181.97 Typical High $234.42 | Professional | None | $125.89 | $181.97 | $234.42 |
Medcost Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $165.96 | Professional | None | $117.49 | $117.49 | $165.96 |
Medcost Setting Facility Modifier None Typical Low $63.10 Median $97.72 Typical High $117.49 | Facility | None | $63.10 | $97.72 | $117.49 |
Medcost Setting Professional Modifier None Typical Low $85.11 Median $112.20 Typical High $223.87 | Professional | None | $85.11 | $112.20 | $223.87 |
Sentara Setting Facility Modifier None Typical Low $87.10 Median $123.03 Typical High $389.05 | Facility | None | $87.10 | $123.03 | $389.05 |
Sentara Setting Professional Modifier None Typical Low $97.72 Median $131.83 Typical High $269.15 | Professional | None | $97.72 | $131.83 | $269.15 |
United Setting Facility Modifier None Typical Low $87.10 Median $100.00 Typical High $239.88 | Facility | None | $87.10 | $100.00 | $239.88 |
United Setting Professional Modifier None Typical Low $79.43 Median $87.10 Typical High $131.83 | Professional | None | $79.43 | $87.10 | $131.83 |
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 $36.31 Median $43.65 Typical High $45.71 | Professional | 52 · Reduced service | $36.31 | $43.65 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $17.38 Typical High $18.20 | Professional | 53 · Discontinued | $14.45 | $17.38 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $13.18 Typical High $13.80 | Professional | 55 · Aftercare only | $10.72 | $13.18 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $8.71 Typical High $9.12 | Professional | 56 · Pre-op care only | $7.24 | $8.71 | $9.12 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $10.96 Median $10.96 Typical High $14.13 | Professional | RR · Rental | $10.96 | $10.96 | $14.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $79.43 Median $81.28 Typical High $81.28 | Professional | UE · Used equipment | $79.43 | $81.28 | $81.28 |
Where Virginia sits
The same service costs 2.5 times more in Hawaii than in Arizona. 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· 38th of 51
$107
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.