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 $74.13 Median $89.13 Typical High $89.13 | Facility | None | $74.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $89.13 Typical High $112.20 | Professional | None | $74.13 | $89.13 | $112.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $194.98 | Facility | None | $186.21 | $186.21 | $194.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $107.15 | Professional | None | $93.33 | $93.33 | $107.15 |
CareFirst Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $125.89 | Professional | None | $97.72 | $97.72 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $125.89 | Facility | None | $117.49 | $117.49 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $117.49 | Professional | None | $85.11 | $85.11 | $117.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $186.21 Typical High $239.88 | Professional | None | $128.82 | $186.21 | $239.88 |
Medcost Setting Professional Modifier None Typical Low $109.65 Median $120.23 Typical High $169.82 | Professional | None | $109.65 | $120.23 | $169.82 |
Medcost Setting Facility Modifier None Typical Low $53.70 Median $100.00 Typical High $120.23 | Facility | None | $53.70 | $100.00 | $120.23 |
Medcost Setting Professional Modifier None Typical Low $74.13 Median $100.00 Typical High $229.09 | Professional | None | $74.13 | $100.00 | $229.09 |
Sentara Setting Facility Modifier None Typical Low $91.20 Median $128.82 Typical High $398.11 | Facility | None | $91.20 | $128.82 | $398.11 |
Sentara Setting Professional Modifier None Typical Low $100.00 Median $134.90 Typical High $281.84 | Professional | None | $100.00 | $134.90 | $281.84 |
United Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $204.17 | Facility | None | $93.33 | $93.33 | $204.17 |
United Setting Professional Modifier None Typical Low $75.86 Median $91.20 Typical High $134.90 | Professional | None | $75.86 | $91.20 | $134.90 |
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 $37.15 Median $44.67 Typical High $44.67 | Professional | 52 · Reduced service | $37.15 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $17.78 Typical High $17.78 | Professional | 53 · Discontinued | $14.79 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $13.49 Typical High $13.49 | Professional | 55 · Aftercare only | $11.22 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $8.91 Typical High $8.91 | Professional | 56 · Pre-op care only | $7.41 | $8.91 | $8.91 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $9.77 Median $9.77 Typical High $12.02 | Professional | RR · Rental | $9.77 | $9.77 | $12.02 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $70.79 Median $72.44 Typical High $75.86 | Professional | UE · Used equipment | $70.79 | $72.44 | $75.86 |
Where Virginia sits
The same service costs 2.4 times more in Hawaii than in Colorado. 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· 31st of 51
$97.72
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.