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 $41.69 Median $50.12 Typical High $50.12 | Facility | None | $41.69 | $50.12 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $50.12 Typical High $50.12 | Professional | None | $41.69 | $50.12 | $50.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $109.65 | Facility | None | $102.33 | $102.33 | $109.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $58.88 | Professional | None | $52.48 | $52.48 | $58.88 |
CareFirst Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $70.79 | Professional | None | $53.70 | $53.70 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $42.66 Median $64.57 Typical High $64.57 | Facility | None | $42.66 | $64.57 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $64.57 | Professional | None | $46.77 | $46.77 | $64.57 |
Kaiser Permanente Setting Professional Modifier None Typical Low $72.44 Median $102.33 Typical High $134.90 | Professional | None | $72.44 | $102.33 | $134.90 |
Medcost Setting Professional Modifier None Typical Low $60.26 Median $67.61 Typical High $95.50 | Professional | None | $60.26 | $67.61 | $95.50 |
Medcost Setting Facility Modifier None Typical Low $30.90 Median $54.95 Typical High $67.61 | Facility | None | $30.90 | $54.95 | $67.61 |
Medcost Setting Professional Modifier None Typical Low $38.90 Median $54.95 Typical High $128.82 | Professional | None | $38.90 | $54.95 | $128.82 |
Sentara Setting Facility Modifier None Typical Low $50.12 Median $70.79 Typical High $223.87 | Facility | None | $50.12 | $70.79 | $223.87 |
Sentara Setting Professional Modifier None Typical Low $54.95 Median $75.86 Typical High $154.88 | Professional | None | $54.95 | $75.86 | $154.88 |
United Setting Facility Modifier None Typical Low $57.54 Median $60.26 Typical High $117.49 | Facility | None | $57.54 | $60.26 | $117.49 |
United Setting Professional Modifier None Typical Low $43.65 Median $50.12 Typical High $75.86 | Professional | None | $43.65 | $50.12 | $75.86 |
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 $20.89 Median $25.12 Typical High $25.12 | Professional | 52 · Reduced service | $20.89 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $10.00 Typical High $10.00 | Professional | 53 · Discontinued | $8.32 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $7.59 Typical High $7.59 | Professional | 55 · Aftercare only | $6.17 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $5.01 Typical High $5.01 | Professional | 56 · Pre-op care only | $4.17 | $5.01 | $5.01 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.37 Median $5.37 Typical High $6.92 | Professional | RR · Rental | $5.37 | $5.37 | $6.92 |
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 3.5 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· 39th of 51
$53.70
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.