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 $275.42 Median $331.13 Typical High $331.13 | Facility | None | $275.42 | $331.13 | $331.13 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $331.13 Typical High $331.13 | Professional | None | $275.42 | $331.13 | $331.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $724.44 | Facility | None | $691.83 | $691.83 | $724.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $478.63 | Professional | None | $389.05 | $389.05 | $478.63 |
CareFirst Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $478.63 | Professional | None | $446.68 | $446.68 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $436.52 Typical High $436.52 | Facility | None | $309.03 | $436.52 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $436.52 | Professional | None | $316.23 | $316.23 | $436.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $478.63 Median $691.83 Typical High $891.25 | Professional | None | $478.63 | $691.83 | $891.25 |
Medcost Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $501.19 | Facility | None | $371.54 | $371.54 | $501.19 |
Medcost Setting Professional Modifier None Typical Low $371.54 Median $416.87 Typical High $870.96 | Professional | None | $371.54 | $416.87 | $870.96 |
Sentara Setting Facility Modifier None Typical Low $380.19 Median $524.81 Typical High $1,047.13 | Facility | None | $380.19 | $524.81 | $1,047.13 |
Sentara Setting Professional Modifier None Typical Low $371.54 Median $524.81 Typical High $933.25 | Professional | None | $371.54 | $524.81 | $933.25 |
United Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $1,000.00 | Facility | None | $851.14 | $851.14 | $1,000.00 |
United Setting Professional Modifier None Typical Low $316.23 Median $338.84 Typical High $524.81 | Professional | None | $316.23 | $338.84 | $524.81 |
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 $138.04 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $138.04 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $54.95 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $41.69 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $27.54 | $33.11 | $33.11 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $38.90 Median $38.90 Typical High $48.98 | Professional | RR · Rental | $38.90 | $38.90 | $48.98 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $295.12 Median $295.12 Typical High $316.23 | Professional | UE · Used equipment | $295.12 | $295.12 | $316.23 |
Where Virginia sits
The same service costs 2.3 times more in Montana than in Delaware. 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· 32nd of 51
$389
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.