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 $93.33 Median $165.96 Typical High $165.96 | Facility | None | $93.33 | $165.96 | $165.96 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $165.96 Typical High $165.96 | Professional | None | $93.33 | $165.96 | $165.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $234.42 | Facility | None | $223.87 | $223.87 | $234.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $208.93 | Professional | None | $194.98 | $194.98 | $208.93 |
CareFirst Setting Professional Modifier None Typical Low $186.21 Median $213.80 Typical High $213.80 | Professional | None | $186.21 | $213.80 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $213.80 Typical High $213.80 | Facility | None | $151.36 | $213.80 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $213.80 | Professional | None | $154.88 | $154.88 | $213.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $138.04 Median $194.98 Typical High $338.84 | Professional | None | $138.04 | $194.98 | $338.84 |
Medcost Setting Facility Modifier None Typical Low $75.86 Median $186.21 Typical High $223.87 | Facility | None | $75.86 | $186.21 | $223.87 |
Medcost Setting Professional Modifier None Typical Low $186.21 Median $208.93 Typical High $275.42 | Professional | None | $186.21 | $208.93 | $275.42 |
Sentara Setting Facility Modifier None Typical Low $144.54 Median $263.03 Typical High $512.86 | Facility | None | $144.54 | $263.03 | $512.86 |
Sentara Setting Professional Modifier None Typical Low $158.49 Median $263.03 Typical High $380.19 | Professional | None | $158.49 | $263.03 | $380.19 |
United Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $416.87 | Facility | None | $346.74 | $346.74 | $416.87 |
United Setting Professional Modifier None Typical Low $154.88 Median $169.82 Typical High $263.03 | Professional | None | $154.88 | $169.82 | $263.03 |
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 $46.77 Median $83.18 Typical High $83.18 | Professional | 52 · Reduced service | $46.77 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $33.11 Typical High $33.11 | Professional | 53 · Discontinued | $18.62 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $25.12 Typical High $25.12 | Professional | 55 · Aftercare only | $14.13 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $16.60 Typical High $16.60 | Professional | 56 · Pre-op care only | $9.33 | $16.60 | $16.60 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $19.50 Median $19.50 Typical High $20.89 | Professional | RR · Rental | $19.50 | $19.50 | $20.89 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $123.03 Median $144.54 Typical High $144.54 | Professional | UE · Used equipment | $123.03 | $144.54 | $144.54 |
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· 23rd of 51
$195
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.