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 $125.89 Median $151.36 Typical High $151.36 | Facility | None | $125.89 | $151.36 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $151.36 Typical High $151.36 | Professional | None | $125.89 | $151.36 | $151.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $331.13 | Facility | None | $316.23 | $316.23 | $331.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $223.87 | Professional | None | $181.97 | $181.97 | $223.87 |
CareFirst Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $213.80 | Professional | None | $165.96 | $165.96 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $218.78 Typical High $218.78 | Facility | None | $144.54 | $218.78 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $218.78 | Professional | None | $158.49 | $158.49 | $218.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $218.78 Median $316.23 Typical High $407.38 | Professional | None | $218.78 | $316.23 | $407.38 |
Medcost Setting Professional Modifier None Typical Low $186.21 Median $204.17 Typical High $288.40 | Professional | None | $186.21 | $204.17 | $288.40 |
Medcost Setting Facility Modifier None Typical Low $107.15 Median $169.82 Typical High $204.17 | Facility | None | $107.15 | $169.82 | $204.17 |
Medcost Setting Professional Modifier None Typical Low $165.96 Median $169.82 Typical High $389.05 | Professional | None | $165.96 | $169.82 | $389.05 |
Sentara Setting Facility Modifier None Typical Low $151.36 Median $218.78 Typical High $676.08 | Facility | None | $151.36 | $218.78 | $676.08 |
Sentara Setting Professional Modifier None Typical Low $169.82 Median $229.09 Typical High $467.74 | Professional | None | $169.82 | $229.09 | $467.74 |
United Setting Facility Modifier None Typical Low $199.53 Median $204.17 Typical High $407.38 | Facility | None | $199.53 | $204.17 | $407.38 |
United Setting Professional Modifier None Typical Low $138.04 Median $154.88 Typical High $229.09 | Professional | None | $138.04 | $154.88 | $229.09 |
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 $63.10 Median $75.86 Typical High $75.86 | Professional | 52 · Reduced service | $63.10 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $30.20 Typical High $30.20 | Professional | 53 · Discontinued | $25.12 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $22.91 Typical High $22.91 | Professional | 55 · Aftercare only | $19.05 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $15.14 Typical High $15.14 | Professional | 56 · Pre-op care only | $12.59 | $15.14 | $15.14 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $18.20 Median $18.20 Typical High $23.99 | Professional | RR · Rental | $18.20 | $18.20 | $23.99 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $138.04 Median $138.04 Typical High $147.91 | Professional | UE · Used equipment | $138.04 | $138.04 | $147.91 |
Where Virginia sits
The same service costs 3.3 times more in Hawaii than in West Virginia. 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
$182
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.