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 $38.02 Median $46.77 Typical High $46.77 | Facility | None | $38.02 | $46.77 | $46.77 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $46.77 Typical High $51.29 | Professional | None | $38.02 | $46.77 | $51.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $102.33 | Facility | None | $95.50 | $95.50 | $102.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $60.26 | Professional | None | $52.48 | $52.48 | $60.26 |
CareFirst Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $66.07 | Professional | None | $50.12 | $50.12 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $45.71 Median $66.07 Typical High $66.07 | Facility | None | $45.71 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $66.07 | Professional | None | $48.98 | $48.98 | $66.07 |
Kaiser Permanente Setting Professional Modifier None Typical Low $67.61 Median $95.50 Typical High $123.03 | Professional | None | $67.61 | $95.50 | $123.03 |
Medcost Setting Professional Modifier None Typical Low $56.23 Median $63.10 Typical High $87.10 | Professional | None | $56.23 | $63.10 | $87.10 |
Medcost Setting Facility Modifier None Typical Low $30.90 Median $51.29 Typical High $63.10 | Facility | None | $30.90 | $51.29 | $63.10 |
Medcost Setting Professional Modifier None Typical Low $38.90 Median $52.48 Typical High $120.23 | Professional | None | $38.90 | $52.48 | $120.23 |
Sentara Setting Facility Modifier None Typical Low $46.77 Median $66.07 Typical High $204.17 | Facility | None | $46.77 | $66.07 | $204.17 |
Sentara Setting Professional Modifier None Typical Low $51.29 Median $70.79 Typical High $144.54 | Professional | None | $51.29 | $70.79 | $144.54 |
United Setting Facility Modifier None Typical Low $47.86 Median $58.88 Typical High $120.23 | Facility | None | $47.86 | $58.88 | $120.23 |
United Setting Professional Modifier None Typical Low $42.66 Median $46.77 Typical High $70.79 | Professional | None | $42.66 | $46.77 | $70.79 |
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 $19.05 Median $23.44 Typical High $25.12 | Professional | 52 · Reduced service | $19.05 | $23.44 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $9.33 Typical High $10.23 | Professional | 53 · Discontinued | $7.76 | $9.33 | $10.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $6.92 Typical High $7.59 | Professional | 55 · Aftercare only | $5.75 | $6.92 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $4.68 Typical High $5.13 | Professional | 56 · Pre-op care only | $3.80 | $4.68 | $5.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.37 Median $5.37 Typical High $7.08 | Professional | RR · Rental | $5.37 | $5.37 | $7.08 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $39.81 Median $40.74 Typical High $40.74 | Professional | UE · Used equipment | $39.81 | $40.74 | $40.74 |
Where Virginia sits
The same service costs 3.4 times more in Hawaii 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· 42nd of 51
$52.48
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.