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 $42.66 Median $52.48 Typical High $52.48 | Facility | None | $42.66 | $52.48 | $52.48 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $52.48 Typical High $52.48 | Professional | None | $42.66 | $52.48 | $52.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $114.82 | Facility | None | $107.15 | $107.15 | $114.82 |
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 $56.23 Median $56.23 Typical High $74.13 | Professional | None | $56.23 | $56.23 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $44.67 Median $61.66 Typical High $61.66 | Facility | None | $44.67 | $61.66 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $61.66 | Professional | None | $44.67 | $44.67 | $61.66 |
Kaiser Permanente Setting Professional Modifier None Typical Low $75.86 Median $107.15 Typical High $138.04 | Professional | None | $75.86 | $107.15 | $138.04 |
Medcost Setting Professional Modifier None Typical Low $63.10 Median $70.79 Typical High $97.72 | Professional | None | $63.10 | $70.79 | $97.72 |
Medcost Setting Facility Modifier None Typical Low $34.67 Median $57.54 Typical High $69.18 | Facility | None | $34.67 | $57.54 | $69.18 |
Medcost Setting Professional Modifier None Typical Low $47.86 Median $63.10 Typical High $134.90 | Professional | None | $47.86 | $63.10 | $134.90 |
Sentara Setting Facility Modifier None Typical Low $52.48 Median $74.13 Typical High $229.09 | Facility | None | $52.48 | $74.13 | $229.09 |
Sentara Setting Professional Modifier None Typical Low $57.54 Median $79.43 Typical High $162.18 | Professional | None | $57.54 | $79.43 | $162.18 |
United Setting Facility Modifier None Typical Low $29.51 Median $48.98 Typical High $134.90 | Facility | None | $29.51 | $48.98 | $134.90 |
United Setting Professional Modifier None Typical Low $47.86 Median $52.48 Typical High $79.43 | Professional | None | $47.86 | $52.48 | $79.43 |
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 $21.38 Median $25.70 Typical High $26.30 | Professional | 52 · Reduced service | $21.38 | $25.70 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $10.47 Typical High $10.47 | Professional | 53 · Discontinued | $8.51 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $7.76 Typical High $7.76 | Professional | 55 · Aftercare only | $6.46 | $7.76 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $5.25 Typical High $5.25 | Professional | 56 · Pre-op care only | $4.27 | $5.25 | $5.25 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.03 Median $6.03 Typical High $7.76 | Professional | RR · Rental | $6.03 | $6.03 | $7.76 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $44.67 Median $44.67 Typical High $48.98 | Professional | UE · Used equipment | $44.67 | $44.67 | $48.98 |
Where Virginia sits
The same service costs 2.4 times more in Montana 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· 36th 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.