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 $102.33 Median $123.03 Typical High $123.03 | Facility | None | $102.33 | $123.03 | $123.03 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $123.03 Typical High $123.03 | Professional | None | $102.33 | $123.03 | $123.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $269.15 | Facility | None | $251.19 | $251.19 | $269.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $134.90 | Professional | None | $120.23 | $120.23 | $134.90 |
CareFirst Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $173.78 | Professional | None | $134.90 | $134.90 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $144.54 Typical High $144.54 | Facility | None | $104.71 | $144.54 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $144.54 | Professional | None | $104.71 | $104.71 | $144.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $177.83 Median $251.19 Typical High $331.13 | Professional | None | $177.83 | $251.19 | $331.13 |
Medcost Setting Professional Modifier None Typical Low $151.36 Median $165.96 Typical High $234.42 | Professional | None | $151.36 | $165.96 | $234.42 |
Medcost Setting Facility Modifier None Typical Low $70.79 Median $134.90 Typical High $165.96 | Facility | None | $70.79 | $134.90 | $165.96 |
Medcost Setting Professional Modifier None Typical Low $89.13 Median $120.23 Typical High $316.23 | Professional | None | $89.13 | $120.23 | $316.23 |
Sentara Setting Facility Modifier None Typical Low $123.03 Median $173.78 Typical High $549.54 | Facility | None | $123.03 | $173.78 | $549.54 |
Sentara Setting Professional Modifier None Typical Low $134.90 Median $186.21 Typical High $380.19 | Professional | None | $134.90 | $186.21 | $380.19 |
United Setting Facility Modifier None Typical Low $87.10 Median $100.00 Typical High $269.15 | Facility | None | $87.10 | $100.00 | $269.15 |
United Setting Professional Modifier None Typical Low $100.00 Median $123.03 Typical High $186.21 | Professional | None | $100.00 | $123.03 | $186.21 |
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 $51.29 Median $61.66 Typical High $61.66 | Professional | 52 · Reduced service | $51.29 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $24.55 Typical High $24.55 | Professional | 53 · Discontinued | $20.42 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $18.62 Typical High $18.62 | Professional | 55 · Aftercare only | $15.14 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $12.30 Typical High $12.30 | Professional | 56 · Pre-op care only | $10.23 | $12.30 | $12.30 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $12.30 Median $12.30 Typical High $16.22 | Professional | RR · Rental | $12.30 | $12.30 | $16.22 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $89.13 Median $93.33 Typical High $93.33 | Professional | UE · Used equipment | $89.13 | $93.33 | $93.33 |
Where Virginia sits
The same service costs 2.5 times more in Montana than in Florida. 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· 35th of 51
$123
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.