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 $83.18 Median $100.00 Typical High $100.00 | Facility | None | $83.18 | $100.00 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $100.00 Typical High $117.49 | Professional | None | $83.18 | $100.00 | $117.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $218.78 | Facility | None | $204.17 | $204.17 | $218.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $151.36 | Professional | None | $123.03 | $123.03 | $151.36 |
CareFirst Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $141.25 | Professional | None | $107.15 | $107.15 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $134.90 Typical High $134.90 | Facility | None | $91.20 | $134.90 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $134.90 | Professional | None | $100.00 | $100.00 | $134.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $144.54 Median $204.17 Typical High $269.15 | Professional | None | $144.54 | $204.17 | $269.15 |
Medcost Setting Professional Modifier None Typical Low $120.23 Median $134.90 Typical High $190.55 | Professional | None | $120.23 | $134.90 | $190.55 |
Medcost Setting Facility Modifier None Typical Low $70.79 Median $109.65 Typical High $134.90 | Facility | None | $70.79 | $109.65 | $134.90 |
Medcost Setting Professional Modifier None Typical Low $89.13 Median $120.23 Typical High $257.04 | Professional | None | $89.13 | $120.23 | $257.04 |
Sentara Setting Facility Modifier None Typical Low $100.00 Median $141.25 Typical High $446.68 | Facility | None | $100.00 | $141.25 | $446.68 |
Sentara Setting Professional Modifier None Typical Low $109.65 Median $151.36 Typical High $309.03 | Professional | None | $109.65 | $151.36 | $309.03 |
United Setting Facility Modifier None Typical Low $63.10 Median $128.82 Typical High $275.42 | Facility | None | $63.10 | $128.82 | $275.42 |
United Setting Professional Modifier None Typical Low $91.20 Median $100.00 Typical High $154.88 | Professional | None | $91.20 | $100.00 | $154.88 |
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 $41.69 Median $50.12 Typical High $58.88 | Professional | 52 · Reduced service | $41.69 | $50.12 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $19.95 Typical High $23.99 | Professional | 53 · Discontinued | $16.60 | $19.95 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $15.14 Typical High $17.78 | Professional | 55 · Aftercare only | $12.30 | $15.14 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $10.00 Typical High $11.75 | Professional | 56 · Pre-op care only | $8.32 | $10.00 | $11.75 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $12.30 Median $12.30 Typical High $16.22 | Professional | RR · Rental | $12.30 | $12.30 | $16.22 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | UE · Used equipment | $91.20 | $91.20 | $91.20 |
Where Virginia sits
The same service costs 3.9 times more in Kansas than in New Jersey. 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· 34th of 51
$123
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.