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 $45.71 Median $54.95 Typical High $54.95 | Facility | None | $45.71 | $54.95 | $54.95 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $54.95 Typical High $54.95 | Professional | None | $45.71 | $54.95 | $54.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $120.23 | Facility | None | $114.82 | $114.82 | $120.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $74.13 | Professional | None | $60.26 | $60.26 | $74.13 |
CareFirst Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $77.62 | Professional | None | $60.26 | $60.26 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $64.57 Typical High $64.57 | Facility | None | $58.88 | $64.57 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $64.57 | Professional | None | $46.77 | $46.77 | $64.57 |
Kaiser Permanente Setting Professional Modifier None Typical Low $79.43 Median $114.82 Typical High $147.91 | Professional | None | $79.43 | $114.82 | $147.91 |
Medcost Setting Professional Modifier None Typical Low $67.61 Median $74.13 Typical High $104.71 | Professional | None | $67.61 | $74.13 | $104.71 |
Medcost Setting Facility Modifier None Typical Low $36.31 Median $61.66 Typical High $74.13 | Facility | None | $36.31 | $61.66 | $74.13 |
Medcost Setting Professional Modifier None Typical Low $45.71 Median $61.66 Typical High $141.25 | Professional | None | $45.71 | $61.66 | $141.25 |
Sentara Setting Facility Modifier None Typical Low $56.23 Median $79.43 Typical High $245.47 | Facility | None | $56.23 | $79.43 | $245.47 |
Sentara Setting Professional Modifier None Typical Low $61.66 Median $83.18 Typical High $173.78 | Professional | None | $61.66 | $83.18 | $173.78 |
United Setting Facility Modifier None Typical Low $50.12 Median $60.26 Typical High $141.25 | Facility | None | $50.12 | $60.26 | $141.25 |
United Setting Professional Modifier None Typical Low $50.12 Median $56.23 Typical High $85.11 | Professional | None | $50.12 | $56.23 | $85.11 |
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 $22.91 Median $27.54 Typical High $27.54 | Professional | 52 · Reduced service | $22.91 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $10.96 Typical High $10.96 | Professional | 53 · Discontinued | $9.12 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $8.32 Typical High $8.32 | Professional | 55 · Aftercare only | $6.92 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $5.50 Typical High $5.50 | Professional | 56 · Pre-op care only | $4.57 | $5.50 | $5.50 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.03 Median $6.03 Typical High $8.51 | Professional | RR · Rental | $6.03 | $6.03 | $8.51 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | UE · Used equipment | $45.71 | $45.71 | $45.71 |
Where Virginia sits
The same service costs 2.8 times more in Wisconsin 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
$60.26
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.