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 $93.33 Median $112.20 Typical High $112.20 | Facility | None | $93.33 | $112.20 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $112.20 Typical High $112.20 | Professional | None | $93.33 | $112.20 | $112.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $245.47 | Facility | None | $229.09 | $229.09 | $245.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $165.96 | Professional | None | $134.90 | $134.90 | $165.96 |
CareFirst Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $158.49 | Professional | None | $120.23 | $120.23 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $141.25 Typical High $141.25 | Facility | None | $97.72 | $141.25 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $141.25 | Professional | None | $102.33 | $102.33 | $141.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $162.18 Median $229.09 Typical High $302.00 | Professional | None | $162.18 | $229.09 | $302.00 |
Medcost Setting Professional Modifier None Typical Low $134.90 Median $151.36 Typical High $208.93 | Professional | None | $134.90 | $151.36 | $208.93 |
Medcost Setting Facility Modifier None Typical Low $79.43 Median $123.03 Typical High $151.36 | Facility | None | $79.43 | $123.03 | $151.36 |
Medcost Setting Professional Modifier None Typical Low $123.03 Median $134.90 Typical High $288.40 | Professional | None | $123.03 | $134.90 | $288.40 |
Sentara Setting Facility Modifier None Typical Low $112.20 Median $158.49 Typical High $489.78 | Facility | None | $112.20 | $158.49 | $489.78 |
Sentara Setting Professional Modifier None Typical Low $123.03 Median $169.82 Typical High $346.74 | Professional | None | $123.03 | $169.82 | $346.74 |
United Setting Facility Modifier None Typical Low $151.36 Median $309.03 Typical High $389.05 | Facility | None | $151.36 | $309.03 | $389.05 |
United Setting Professional Modifier None Typical Low $102.33 Median $112.20 Typical High $169.82 | Professional | None | $102.33 | $112.20 | $169.82 |
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 $45.71 Median $56.23 Typical High $56.23 | Professional | 52 · Reduced service | $45.71 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $22.39 Typical High $22.39 | Professional | 53 · Discontinued | $18.62 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $16.60 Typical High $16.60 | Professional | 55 · Aftercare only | $13.80 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $11.22 Typical High $11.22 | Professional | 56 · Pre-op care only | $9.33 | $11.22 | $11.22 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $13.49 Median $13.49 Typical High $16.98 | Professional | RR · Rental | $13.49 | $13.49 | $16.98 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | UE · Used equipment | $100.00 | $100.00 | $100.00 |
Where Virginia sits
The same service costs 8.1 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· 34th of 51
$135
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.