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 $25.70 Median $45.71 Typical High $45.71 | Facility | None | $25.70 | $45.71 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $45.71 Typical High $45.71 | Professional | None | $25.70 | $45.71 | $45.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $64.57 | Facility | None | $60.26 | $60.26 | $64.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $57.54 | Professional | None | $53.70 | $53.70 | $57.54 |
CareFirst Setting Professional Modifier None Typical Low $50.12 Median $57.54 Typical High $57.54 | Professional | None | $50.12 | $57.54 | $57.54 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $52.48 Typical High $52.48 | Facility | None | $34.67 | $52.48 | $52.48 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $52.48 | Professional | None | $44.67 | $44.67 | $52.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $37.15 Median $53.70 Typical High $93.33 | Professional | None | $37.15 | $53.70 | $93.33 |
Medcost Setting Facility Modifier None Typical Low $20.89 Median $50.12 Typical High $61.66 | Facility | None | $20.89 | $50.12 | $61.66 |
Medcost Setting Professional Modifier None Typical Low $50.12 Median $56.23 Typical High $75.86 | Professional | None | $50.12 | $56.23 | $75.86 |
Sentara Setting Facility Modifier None Typical Low $39.81 Median $72.44 Typical High $141.25 | Facility | None | $39.81 | $72.44 | $141.25 |
Sentara Setting Professional Modifier None Typical Low $43.65 Median $72.44 Typical High $104.71 | Professional | None | $43.65 | $72.44 | $104.71 |
United Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $112.20 | Facility | None | $93.33 | $93.33 | $112.20 |
United Setting Professional Modifier None Typical Low $41.69 Median $45.71 Typical High $72.44 | Professional | None | $41.69 | $45.71 | $72.44 |
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 $12.88 Median $22.91 Typical High $22.91 | Professional | 52 · Reduced service | $12.88 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $9.12 Typical High $9.12 | Professional | 53 · Discontinued | $5.13 | $9.12 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $6.76 Typical High $6.76 | Professional | 55 · Aftercare only | $3.80 | $6.76 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $4.57 Typical High $4.57 | Professional | 56 · Pre-op care only | $2.57 | $4.57 | $4.57 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.37 Median $5.37 Typical High $5.75 | Professional | RR · Rental | $5.37 | $5.37 | $5.75 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $34.67 Median $40.74 Typical High $40.74 | Professional | UE · Used equipment | $34.67 | $40.74 | $40.74 |
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
$53.70
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.