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 $208.93 Median $251.19 Typical High $251.19 | Facility | None | $208.93 | $251.19 | $251.19 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $251.19 Typical High $269.15 | Professional | None | $208.93 | $251.19 | $269.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $549.54 | Facility | None | $524.81 | $524.81 | $549.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $380.19 | Professional | None | $309.03 | $309.03 | $380.19 |
CareFirst Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $363.08 | Professional | None | $275.42 | $275.42 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $363.08 Typical High $363.08 | Facility | None | $295.12 | $363.08 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $363.08 | Professional | None | $263.03 | $263.03 | $363.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $363.08 Median $524.81 Typical High $676.08 | Professional | None | $363.08 | $524.81 | $676.08 |
Medcost Setting Professional Modifier None Typical Low $309.03 Median $338.84 Typical High $478.63 | Professional | None | $309.03 | $338.84 | $478.63 |
Medcost Setting Facility Modifier None Typical Low $181.97 Median $281.84 Typical High $338.84 | Facility | None | $181.97 | $281.84 | $338.84 |
Medcost Setting Professional Modifier None Typical Low $263.03 Median $309.03 Typical High $660.69 | Professional | None | $263.03 | $309.03 | $660.69 |
Sentara Setting Facility Modifier None Typical Low $257.04 Median $363.08 Typical High $1,122.02 | Facility | None | $257.04 | $363.08 | $1,122.02 |
Sentara Setting Professional Modifier None Typical Low $281.84 Median $389.05 Typical High $794.33 | Professional | None | $281.84 | $389.05 | $794.33 |
United Setting Facility Modifier None Typical Low $338.84 Median $363.08 Typical High $691.83 | Facility | None | $338.84 | $363.08 | $691.83 |
United Setting Professional Modifier None Typical Low $229.09 Median $257.04 Typical High $389.05 | Professional | None | $229.09 | $257.04 | $389.05 |
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 $104.71 Median $125.89 Typical High $125.89 | Professional | 52 · Reduced service | $104.71 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $51.29 Typical High $51.29 | Professional | 53 · Discontinued | $41.69 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $38.02 Typical High $38.02 | Professional | 55 · Aftercare only | $31.62 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $25.12 Typical High $25.12 | Professional | 56 · Pre-op care only | $20.89 | $25.12 | $25.12 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $30.90 Median $30.90 Typical High $39.81 | Professional | RR · Rental | $30.90 | $30.90 | $39.81 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $213.80 Median $229.09 Typical High $229.09 | Professional | UE · Used equipment | $213.80 | $229.09 | $229.09 |
Where Virginia sits
The same service costs 3.3 times more in Hawaii than in West Virginia. 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· 35th of 51
$309
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.