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 $56.23 Median $67.61 Typical High $67.61 | Facility | None | $56.23 | $67.61 | $67.61 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $67.61 Typical High $67.61 | Professional | None | $56.23 | $67.61 | $67.61 |
Anthem BCBS Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $147.91 | Facility | None | $138.04 | $138.04 | $147.91 |
Anthem BCBS Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $87.10 | Professional | None | $70.79 | $70.79 | $87.10 |
CareFirst Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $95.50 | Professional | None | $72.44 | $72.44 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $75.86 Typical High $75.86 | Facility | None | $50.12 | $75.86 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $75.86 | Professional | None | $54.95 | $54.95 | $75.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $97.72 Median $138.04 Typical High $181.97 | Professional | None | $97.72 | $138.04 | $181.97 |
Medcost Setting Professional Modifier None Typical Low $81.28 Median $91.20 Typical High $125.89 | Professional | None | $81.28 | $91.20 | $125.89 |
Medcost Setting Facility Modifier None Typical Low $40.74 Median $74.13 Typical High $91.20 | Facility | None | $40.74 | $74.13 | $91.20 |
Medcost Setting Professional Modifier None Typical Low $57.54 Median $74.13 Typical High $173.78 | Professional | None | $57.54 | $74.13 | $173.78 |
Sentara Setting Facility Modifier None Typical Low $67.61 Median $95.50 Typical High $295.12 | Facility | None | $67.61 | $95.50 | $295.12 |
Sentara Setting Professional Modifier None Typical Low $74.13 Median $102.33 Typical High $208.93 | Professional | None | $74.13 | $102.33 | $208.93 |
United Setting Facility Modifier None Typical Low $77.62 Median $87.10 Typical High $158.49 | Facility | None | $77.62 | $87.10 | $158.49 |
United Setting Professional Modifier None Typical Low $57.54 Median $67.61 Typical High $102.33 | Professional | None | $57.54 | $67.61 | $102.33 |
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 $27.54 Median $33.88 Typical High $33.88 | Professional | 52 · Reduced service | $27.54 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $13.49 Typical High $13.49 | Professional | 53 · Discontinued | $11.22 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $10.00 Typical High $10.00 | Professional | 55 · Aftercare only | $8.32 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $6.76 Typical High $6.76 | Professional | 56 · Pre-op care only | $5.62 | $6.76 | $6.76 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $7.08 Median $7.08 Typical High $9.12 | Professional | RR · Rental | $7.08 | $7.08 | $9.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | UE · Used equipment | $52.48 | $52.48 | $52.48 |
Where Virginia sits
The same service costs 4.4 times more in Kansas than in Vermont. 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· 32nd of 51
$70.79
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.