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 $117.49 Median $141.25 Typical High $141.25 | Facility | None | $117.49 | $141.25 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $141.25 Typical High $141.25 | Professional | None | $117.49 | $141.25 | $141.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $309.03 | Facility | None | $295.12 | $295.12 | $309.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $213.80 | Professional | None | $173.78 | $173.78 | $213.80 |
CareFirst Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $199.53 | Professional | None | $154.88 | $154.88 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $223.87 Typical High $223.87 | Facility | None | $165.96 | $223.87 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $223.87 | Professional | None | $165.96 | $165.96 | $223.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $204.17 Median $295.12 Typical High $380.19 | Professional | None | $204.17 | $295.12 | $380.19 |
Medcost Setting Professional Modifier None Typical Low $173.78 Median $190.55 Typical High $269.15 | Professional | None | $173.78 | $190.55 | $269.15 |
Medcost Setting Facility Modifier None Typical Low $102.33 Median $158.49 Typical High $190.55 | Facility | None | $102.33 | $158.49 | $190.55 |
Medcost Setting Professional Modifier None Typical Low $128.82 Median $169.82 Typical High $363.08 | Professional | None | $128.82 | $169.82 | $363.08 |
Sentara Setting Facility Modifier None Typical Low $144.54 Median $204.17 Typical High $630.96 | Facility | None | $144.54 | $204.17 | $630.96 |
Sentara Setting Professional Modifier None Typical Low $158.49 Median $213.80 Typical High $446.68 | Professional | None | $158.49 | $213.80 | $446.68 |
United Setting Facility Modifier None Typical Low $190.55 Median $208.93 Typical High $389.05 | Facility | None | $190.55 | $208.93 | $389.05 |
United Setting Professional Modifier None Typical Low $128.82 Median $144.54 Typical High $213.80 | Professional | None | $128.82 | $144.54 | $213.80 |
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 $58.88 Median $70.79 Typical High $70.79 | Professional | 52 · Reduced service | $58.88 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $28.18 Typical High $28.18 | Professional | 53 · Discontinued | $23.44 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $21.38 Typical High $21.38 | Professional | 55 · Aftercare only | $17.78 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $14.13 Typical High $14.13 | Professional | 56 · Pre-op care only | $11.75 | $14.13 | $14.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $17.38 Median $17.38 Typical High $23.44 | Professional | RR · Rental | $17.38 | $17.38 | $23.44 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $131.83 Median $131.83 Typical High $141.25 | Professional | UE · Used equipment | $131.83 | $131.83 | $141.25 |
Where Virginia sits
The same service costs 3.4 times more in Hawaii than in Washington, DC. 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· 35th of 51
$174
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.