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 $53.70 Median $66.07 Typical High $66.07 | Facility | None | $53.70 | $66.07 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $66.07 Typical High $66.07 | Professional | None | $53.70 | $66.07 | $66.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $144.54 | Facility | None | $134.90 | $134.90 | $144.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $91.20 | Professional | None | $79.43 | $79.43 | $91.20 |
CareFirst Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $93.33 | Professional | None | $70.79 | $70.79 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $107.15 Typical High $107.15 | Facility | None | $69.18 | $107.15 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $107.15 | Professional | None | $77.62 | $77.62 | $107.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $95.50 Median $134.90 Typical High $177.83 | Professional | None | $95.50 | $134.90 | $177.83 |
Medcost Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $123.03 | Professional | None | $89.13 | $89.13 | $123.03 |
Medcost Setting Facility Modifier None Typical Low $46.77 Median $72.44 Typical High $89.13 | Facility | None | $46.77 | $72.44 | $89.13 |
Medcost Setting Professional Modifier None Typical Low $58.88 Median $75.86 Typical High $169.82 | Professional | None | $58.88 | $75.86 | $169.82 |
Sentara Setting Facility Modifier None Typical Low $66.07 Median $93.33 Typical High $288.40 | Facility | None | $66.07 | $93.33 | $288.40 |
Sentara Setting Professional Modifier None Typical Low $72.44 Median $100.00 Typical High $204.17 | Professional | None | $72.44 | $100.00 | $204.17 |
United Setting Facility Modifier None Typical Low $89.13 Median $181.97 Typical High $870.96 | Facility | None | $89.13 | $181.97 | $870.96 |
United Setting Professional Modifier None Typical Low $60.26 Median $66.07 Typical High $100.00 | Professional | None | $60.26 | $66.07 | $100.00 |
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 $26.92 Median $33.11 Typical High $33.11 | Professional | 52 · Reduced service | $26.92 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $13.18 Typical High $13.18 | Professional | 53 · Discontinued | $10.96 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $9.77 Typical High $9.77 | Professional | 55 · Aftercare only | $8.13 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $6.61 Typical High $6.61 | Professional | 56 · Pre-op care only | $5.37 | $6.61 | $6.61 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $8.13 Median $8.13 Typical High $10.72 | Professional | RR · Rental | $8.13 | $8.13 | $10.72 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $58.88 Median $61.66 Typical High $61.66 | Professional | UE · Used equipment | $58.88 | $61.66 | $61.66 |
Where Virginia sits
The same service costs 5.1 times more in Hawaii than in Florida. 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· 39th of 51
$79.43
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.