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 $87.10 Median $104.71 Typical High $104.71 | Facility | None | $87.10 | $104.71 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $104.71 Typical High $104.71 | Professional | None | $87.10 | $104.71 | $104.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $229.09 | Facility | None | $218.78 | $218.78 | $229.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $123.03 | Professional | None | $100.00 | $100.00 | $123.03 |
CareFirst Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $147.91 | Professional | None | $114.82 | $114.82 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $79.43 Median $120.23 Typical High $120.23 | Facility | None | $79.43 | $120.23 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $120.23 | Professional | None | $87.10 | $87.10 | $120.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $151.36 Median $218.78 Typical High $281.84 | Professional | None | $151.36 | $218.78 | $281.84 |
Medcost Setting Professional Modifier None Typical Low $128.82 Median $141.25 Typical High $199.53 | Professional | None | $128.82 | $141.25 | $199.53 |
Medcost Setting Facility Modifier None Typical Low $60.26 Median $117.49 Typical High $141.25 | Facility | None | $60.26 | $117.49 | $141.25 |
Medcost Setting Professional Modifier None Typical Low $83.18 Median $114.82 Typical High $269.15 | Professional | None | $83.18 | $114.82 | $269.15 |
Sentara Setting Facility Modifier None Typical Low $104.71 Median $147.91 Typical High $467.74 | Facility | None | $104.71 | $147.91 | $467.74 |
Sentara Setting Professional Modifier None Typical Low $117.49 Median $158.49 Typical High $323.59 | Professional | None | $117.49 | $158.49 | $323.59 |
United Setting Facility Modifier None Typical Low $72.44 Median $85.11 Typical High $229.09 | Facility | None | $72.44 | $85.11 | $229.09 |
United Setting Professional Modifier None Typical Low $85.11 Median $104.71 Typical High $158.49 | Professional | None | $85.11 | $104.71 | $158.49 |
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 $43.65 Median $52.48 Typical High $52.48 | Professional | 52 · Reduced service | $43.65 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $20.89 Typical High $20.89 | Professional | 53 · Discontinued | $17.38 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $15.85 Typical High $15.85 | Professional | 55 · Aftercare only | $12.88 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $10.47 Typical High $10.47 | Professional | 56 · Pre-op care only | $8.71 | $10.47 | $10.47 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $10.00 Median $10.00 Typical High $13.49 | Professional | RR · Rental | $10.00 | $10.00 | $13.49 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $74.13 Median $74.13 Typical High $81.28 | Professional | UE · Used equipment | $74.13 | $74.13 | $81.28 |
Where Virginia sits
The same service costs 2.4 times more in Montana than in Vermont. 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
$105
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.