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 $120.23 Median $144.54 Typical High $144.54 | Facility | None | $120.23 | $144.54 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $144.54 Typical High $144.54 | Professional | None | $120.23 | $144.54 | $144.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $316.23 | Facility | None | $302.00 | $302.00 | $316.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $177.83 | Professional | None | $158.49 | $158.49 | $177.83 |
CareFirst Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $204.17 | Professional | None | $158.49 | $158.49 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $190.55 Typical High $190.55 | Facility | None | $128.82 | $190.55 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $190.55 | Professional | None | $138.04 | $138.04 | $190.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $208.93 Median $302.00 Typical High $389.05 | Professional | None | $208.93 | $302.00 | $389.05 |
Medcost Setting Professional Modifier None Typical Low $177.83 Median $194.98 Typical High $275.42 | Professional | None | $177.83 | $194.98 | $275.42 |
Medcost Setting Facility Modifier None Typical Low $93.33 Median $162.18 Typical High $194.98 | Facility | None | $93.33 | $162.18 | $194.98 |
Medcost Setting Professional Modifier None Typical Low $117.49 Median $154.88 Typical High $371.54 | Professional | None | $117.49 | $154.88 | $371.54 |
Sentara Setting Facility Modifier None Typical Low $144.54 Median $208.93 Typical High $645.65 | Facility | None | $144.54 | $208.93 | $645.65 |
Sentara Setting Professional Modifier None Typical Low $162.18 Median $218.78 Typical High $457.09 | Professional | None | $162.18 | $218.78 | $457.09 |
United Setting Facility Modifier None Typical Low $147.91 Median $151.36 Typical High $354.81 | Facility | None | $147.91 | $151.36 | $354.81 |
United Setting Professional Modifier None Typical Low $128.82 Median $147.91 Typical High $218.78 | Professional | None | $128.82 | $147.91 | $218.78 |
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 $60.26 Median $72.44 Typical High $72.44 | Professional | 52 · Reduced service | $60.26 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $28.84 Typical High $28.84 | Professional | 53 · Discontinued | $23.99 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $21.88 Typical High $21.88 | Professional | 55 · Aftercare only | $18.20 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $14.45 Typical High $14.45 | Professional | 56 · Pre-op care only | $12.02 | $14.45 | $14.45 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $16.22 Median $16.22 Typical High $20.89 | Professional | RR · Rental | $16.22 | $16.22 | $20.89 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $117.49 Median $123.03 Typical High $128.82 | Professional | UE · Used equipment | $117.49 | $123.03 | $128.82 |
Where Virginia sits
The same service costs 2.3 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· 34th of 51
$158
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.