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 $114.82 Median $199.53 Typical High $199.53 | Facility | None | $114.82 | $199.53 | $199.53 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $199.53 Typical High $199.53 | Professional | None | $114.82 | $199.53 | $199.53 |
Anthem BCBS Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $288.40 | Facility | None | $269.15 | $269.15 | $288.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $257.04 | Professional | None | $239.88 | $239.88 | $257.04 |
CareFirst Setting Professional Modifier None Typical Low $223.87 Median $257.04 Typical High $257.04 | Professional | None | $223.87 | $257.04 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $275.42 Typical High $275.42 | Facility | None | $186.21 | $275.42 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $275.42 | Professional | None | $204.17 | $204.17 | $275.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $165.96 Median $234.42 Typical High $407.38 | Professional | None | $165.96 | $234.42 | $407.38 |
Medcost Setting Facility Modifier None Typical Low $93.33 Median $223.87 Typical High $269.15 | Facility | None | $93.33 | $223.87 | $269.15 |
Medcost Setting Professional Modifier None Typical Low $223.87 Median $251.19 Typical High $338.84 | Professional | None | $223.87 | $251.19 | $338.84 |
Sentara Setting Facility Modifier None Typical Low $177.83 Median $316.23 Typical High $630.96 | Facility | None | $177.83 | $316.23 | $630.96 |
Sentara Setting Professional Modifier None Typical Low $194.98 Median $316.23 Typical High $467.74 | Professional | None | $194.98 | $316.23 | $467.74 |
United Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $501.19 | Facility | None | $416.87 | $416.87 | $501.19 |
United Setting Professional Modifier None Typical Low $186.21 Median $204.17 Typical High $316.23 | Professional | None | $186.21 | $204.17 | $316.23 |
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 $57.54 Median $100.00 Typical High $100.00 | Professional | 52 · Reduced service | $57.54 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $40.74 Typical High $40.74 | Professional | 53 · Discontinued | $22.91 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $30.20 Typical High $30.20 | Professional | 55 · Aftercare only | $16.98 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $19.95 Typical High $19.95 | Professional | 56 · Pre-op care only | $11.48 | $19.95 | $19.95 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $23.99 Median $23.99 Typical High $25.70 | Professional | RR · Rental | $23.99 | $23.99 | $25.70 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $151.36 Median $177.83 Typical High $177.83 | Professional | UE · Used equipment | $151.36 | $177.83 | $177.83 |
Where Virginia sits
The same service costs 2.6 times more in Hawaii than in Utah. 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· 19th of 51
$240
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.