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 $60.26 Median $72.44 Typical High $72.44 | Facility | None | $60.26 | $72.44 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $72.44 Typical High $85.11 | Professional | None | $60.26 | $72.44 | $85.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $158.49 | Facility | None | $147.91 | $147.91 | $158.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $95.50 | Professional | None | $85.11 | $85.11 | $95.50 |
CareFirst Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $102.33 | Professional | None | $79.43 | $79.43 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $102.33 Typical High $102.33 | Facility | None | $77.62 | $102.33 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $102.33 | Professional | None | $74.13 | $74.13 | $102.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $104.71 Median $147.91 Typical High $194.98 | Professional | None | $104.71 | $147.91 | $194.98 |
Medcost Setting Professional Modifier None Typical Low $89.13 Median $97.72 Typical High $138.04 | Professional | None | $89.13 | $97.72 | $138.04 |
Medcost Setting Facility Modifier None Typical Low $50.12 Median $79.43 Typical High $97.72 | Facility | None | $50.12 | $79.43 | $97.72 |
Medcost Setting Professional Modifier None Typical Low $63.10 Median $79.43 Typical High $186.21 | Professional | None | $63.10 | $79.43 | $186.21 |
Sentara Setting Facility Modifier None Typical Low $72.44 Median $102.33 Typical High $323.59 | Facility | None | $72.44 | $102.33 | $323.59 |
Sentara Setting Professional Modifier None Typical Low $79.43 Median $109.65 Typical High $223.87 | Professional | None | $79.43 | $109.65 | $223.87 |
United Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $229.09 | Facility | None | $87.10 | $87.10 | $229.09 |
United Setting Professional Modifier None Typical Low $66.07 Median $72.44 Typical High $109.65 | Professional | None | $66.07 | $72.44 | $109.65 |
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 $30.20 Median $36.31 Typical High $36.31 | Professional | 52 · Reduced service | $30.20 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $14.45 Typical High $14.45 | Professional | 53 · Discontinued | $12.02 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $10.96 Typical High $10.96 | Professional | 55 · Aftercare only | $8.91 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $7.24 Typical High $7.24 | Professional | 56 · Pre-op care only | $6.03 | $7.24 | $7.24 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $8.71 Median $8.71 Typical High $11.22 | Professional | RR · Rental | $8.71 | $8.71 | $11.22 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $63.10 Median $66.07 Typical High $72.44 | Professional | UE · Used equipment | $63.10 | $66.07 | $72.44 |
Where Virginia sits
The same service costs 2.9 times more in Hawaii than in New Jersey. 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
$85.11
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.