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 $38.02 Median $45.71 Typical High $45.71 | Facility | None | $38.02 | $45.71 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $45.71 Typical High $48.98 | Professional | None | $38.02 | $45.71 | $48.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $100.00 | Facility | None | $93.33 | $93.33 | $100.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $63.10 | Professional | None | $54.95 | $54.95 | $63.10 |
CareFirst Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $64.57 | Professional | None | $48.98 | $48.98 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $63.10 Typical High $63.10 | Facility | None | $48.98 | $63.10 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $63.10 | Professional | None | $45.71 | $45.71 | $63.10 |
Kaiser Permanente Setting Professional Modifier None Typical Low $66.07 Median $93.33 Typical High $123.03 | Professional | None | $66.07 | $93.33 | $123.03 |
Medcost Setting Professional Modifier None Typical Low $54.95 Median $61.66 Typical High $87.10 | Professional | None | $54.95 | $61.66 | $87.10 |
Medcost Setting Facility Modifier None Typical Low $32.36 Median $50.12 Typical High $61.66 | Facility | None | $32.36 | $50.12 | $61.66 |
Medcost Setting Professional Modifier None Typical Low $46.77 Median $50.12 Typical High $117.49 | Professional | None | $46.77 | $50.12 | $117.49 |
Sentara Setting Facility Modifier None Typical Low $45.71 Median $64.57 Typical High $204.17 | Facility | None | $45.71 | $64.57 | $204.17 |
Sentara Setting Professional Modifier None Typical Low $50.12 Median $69.18 Typical High $141.25 | Professional | None | $50.12 | $69.18 | $141.25 |
United Setting Facility Modifier None Typical Low $61.66 Median $63.10 Typical High $125.89 | Facility | None | $61.66 | $63.10 | $125.89 |
United Setting Professional Modifier None Typical Low $41.69 Median $45.71 Typical High $69.18 | Professional | None | $41.69 | $45.71 | $69.18 |
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 $19.05 Median $22.91 Typical High $22.91 | Professional | 52 · Reduced service | $19.05 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $9.12 Typical High $9.12 | Professional | 53 · Discontinued | $7.59 | $9.12 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $6.92 Typical High $6.92 | Professional | 55 · Aftercare only | $5.62 | $6.92 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $4.57 Typical High $4.57 | Professional | 56 · Pre-op care only | $3.80 | $4.57 | $4.57 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.75 Median $5.75 Typical High $7.24 | Professional | RR · Rental | $5.75 | $5.75 | $7.24 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $41.69 Median $42.66 Typical High $42.66 | Professional | UE · Used equipment | $41.69 | $42.66 | $42.66 |
Where Virginia sits
The same service costs 4.3 times more in Hawaii 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· 37th of 51
$54.95
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.