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 $54.95 Median $67.61 Typical High $67.61 | Facility | None | $54.95 | $67.61 | $67.61 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $67.61 Typical High $131.83 | Professional | None | $54.95 | $67.61 | $131.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $147.91 | Facility | None | $138.04 | $138.04 | $147.91 |
Anthem BCBS Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $95.50 | Professional | None | $81.28 | $81.28 | $95.50 |
CareFirst Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $95.50 | Professional | None | $72.44 | $72.44 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $87.10 Typical High $87.10 | Facility | None | $81.28 | $87.10 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $87.10 | Professional | None | $63.10 | $63.10 | $87.10 |
Kaiser Permanente Setting Professional Modifier None Typical Low $97.72 Median $138.04 Typical High $177.83 | Professional | None | $97.72 | $138.04 | $177.83 |
Medcost Setting Professional Modifier None Typical Low $81.28 Median $91.20 Typical High $125.89 | Professional | None | $81.28 | $91.20 | $125.89 |
Medcost Setting Facility Modifier None Typical Low $47.86 Median $74.13 Typical High $89.13 | Facility | None | $47.86 | $74.13 | $89.13 |
Medcost Setting Professional Modifier None Typical Low $61.66 Median $74.13 Typical High $173.78 | Professional | None | $61.66 | $74.13 | $173.78 |
Sentara Setting Facility Modifier None Typical Low $67.61 Median $95.50 Typical High $288.40 | Facility | None | $67.61 | $95.50 | $288.40 |
Sentara Setting Professional Modifier None Typical Low $74.13 Median $97.72 Typical High $204.17 | Professional | None | $74.13 | $97.72 | $204.17 |
United Setting Facility Modifier None Typical Low $91.20 Median $120.23 Typical High $186.21 | Facility | None | $91.20 | $120.23 | $186.21 |
United Setting Professional Modifier None Typical Low $61.66 Median $67.61 Typical High $102.33 | Professional | None | $61.66 | $67.61 | $102.33 |
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 $27.54 Median $33.88 Typical High $33.88 | Professional | 52 · Reduced service | $27.54 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $13.49 Typical High $13.80 | Professional | 53 · Discontinued | $10.96 | $13.49 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $10.00 Typical High $10.23 | Professional | 55 · Aftercare only | $8.32 | $10.00 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $6.76 Typical High $6.92 | Professional | 56 · Pre-op care only | $5.50 | $6.76 | $6.92 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $8.51 Median $8.51 Typical High $10.72 | Professional | RR · Rental | $8.51 | $8.51 | $10.72 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $61.66 Median $63.10 Typical High $63.10 | Professional | UE · Used equipment | $61.66 | $63.10 | $63.10 |
Where Virginia sits
The same service costs 5.0 times more in Hawaii 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· 38th of 51
$81.28
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.