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 $39.81 Median $47.86 Typical High $47.86 | Facility | None | $39.81 | $47.86 | $47.86 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $47.86 Typical High $48.98 | Professional | None | $39.81 | $47.86 | $48.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $104.71 | Facility | None | $100.00 | $100.00 | $104.71 |
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 $52.48 Median $52.48 Typical High $67.61 | Professional | None | $52.48 | $52.48 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $63.10 Typical High $63.10 | Facility | None | $52.48 | $63.10 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $63.10 | Professional | None | $45.71 | $45.71 | $63.10 |
Kaiser Permanente Setting Professional Modifier None Typical Low $69.18 Median $100.00 Typical High $128.82 | Professional | None | $69.18 | $100.00 | $128.82 |
Medcost Setting Professional Modifier None Typical Low $58.88 Median $64.57 Typical High $91.20 | Professional | None | $58.88 | $64.57 | $91.20 |
Medcost Setting Facility Modifier None Typical Low $30.90 Median $53.70 Typical High $64.57 | Facility | None | $30.90 | $53.70 | $64.57 |
Medcost Setting Professional Modifier None Typical Low $39.81 Median $53.70 Typical High $123.03 | Professional | None | $39.81 | $53.70 | $123.03 |
Sentara Setting Facility Modifier None Typical Low $48.98 Median $69.18 Typical High $213.80 | Facility | None | $48.98 | $69.18 | $213.80 |
Sentara Setting Professional Modifier None Typical Low $53.70 Median $72.44 Typical High $151.36 | Professional | None | $53.70 | $72.44 | $151.36 |
United Setting Facility Modifier None Typical Low $56.23 Median $58.88 Typical High $120.23 | Facility | None | $56.23 | $58.88 | $120.23 |
United Setting Professional Modifier None Typical Low $43.65 Median $48.98 Typical High $74.13 | Professional | None | $43.65 | $48.98 | $74.13 |
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 $19.95 Median $23.99 Typical High $24.55 | Professional | 52 · Reduced service | $19.95 | $23.99 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $9.55 Typical High $9.77 | Professional | 53 · Discontinued | $7.94 | $9.55 | $9.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $7.24 Typical High $7.24 | Professional | 55 · Aftercare only | $6.03 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $4.79 Typical High $4.90 | Professional | 56 · Pre-op care only | $3.98 | $4.79 | $4.90 |
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 $42.66 | Professional | UE · Used equipment | $39.81 | $40.74 | $42.66 |
Where Virginia sits
The same service costs 3.2 times more in Hawaii 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· 43rd 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.