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 $10.72 Median $12.88 Typical High $12.88 | Facility | None | $10.72 | $12.88 | $12.88 |
Aetna Setting Professional Modifier None Typical Low $10.72 Median $12.88 Typical High $12.88 | Professional | None | $10.72 | $12.88 | $12.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $26.30 Median $26.30 Typical High $28.18 | Facility | None | $26.30 | $26.30 | $28.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $14.13 | Professional | None | $11.48 | $11.48 | $14.13 |
CareFirst Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $18.20 | Professional | None | $14.13 | $14.13 | $18.20 |
Cigna Setting Facility Modifier None Typical Low $8.91 Median $13.49 Typical High $13.49 | Facility | None | $8.91 | $13.49 | $13.49 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $13.49 | Professional | None | $9.77 | $9.77 | $13.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $18.62 Median $26.30 Typical High $34.67 | Professional | None | $18.62 | $26.30 | $34.67 |
Medcost Setting Professional Modifier None Typical Low $15.49 Median $17.38 Typical High $24.55 | Professional | None | $15.49 | $17.38 | $24.55 |
Medcost Setting Facility Modifier None Typical Low $6.92 Median $14.13 Typical High $17.38 | Facility | None | $6.92 | $14.13 | $17.38 |
Medcost Setting Professional Modifier None Typical Low $8.71 Median $11.75 Typical High $33.11 | Professional | None | $8.71 | $11.75 | $33.11 |
Sentara Setting Facility Modifier None Typical Low $12.88 Median $18.20 Typical High $57.54 | Facility | None | $12.88 | $18.20 | $57.54 |
Sentara Setting Professional Modifier None Typical Low $14.13 Median $19.50 Typical High $39.81 | Professional | None | $14.13 | $19.50 | $39.81 |
United Setting Facility Modifier None Typical Low $7.94 Median $9.77 Typical High $26.92 | Facility | None | $7.94 | $9.77 | $26.92 |
United Setting Professional Modifier None Typical Low $9.77 Median $12.88 Typical High $19.50 | Professional | None | $9.77 | $12.88 | $19.50 |
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 $5.37 Median $6.46 Typical High $6.46 | Professional | 52 · Reduced service | $5.37 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.14 Median $2.57 Typical High $2.57 | Professional | 53 · Discontinued | $2.14 | $2.57 | $2.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.58 Median $1.91 Typical High $1.91 | Professional | 55 · Aftercare only | $1.58 | $1.91 | $1.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.07 Median $1.29 Typical High $1.29 | Professional | 56 · Pre-op care only | $1.07 | $1.29 | $1.29 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.15 Median $1.15 Typical High $1.58 | Professional | RR · Rental | $1.15 | $1.15 | $1.58 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | UE · Used equipment | $8.71 | $8.71 | $8.71 |
Where Virginia sits
The same service costs 2.5 times more in Arkansas than in Kansas. 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· 28th of 51
$12.88
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.