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 $66.07 Median $79.43 Typical High $79.43 | Facility | None | $66.07 | $79.43 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $79.43 Typical High $79.43 | Professional | None | $66.07 | $79.43 | $79.43 |
Anthem BCBS Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $173.78 | Facility | None | $165.96 | $165.96 | $173.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $114.82 | Professional | None | $87.10 | $87.10 | $114.82 |
CareFirst Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $112.20 | Professional | None | $85.11 | $85.11 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $89.13 Typical High $89.13 | Facility | None | $85.11 | $89.13 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $89.13 | Professional | None | $66.07 | $66.07 | $89.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $114.82 Median $165.96 Typical High $213.80 | Professional | None | $114.82 | $165.96 | $213.80 |
Medcost Setting Professional Modifier None Typical Low $97.72 Median $107.15 Typical High $151.36 | Professional | None | $97.72 | $107.15 | $151.36 |
Medcost Setting Facility Modifier None Typical Low $48.98 Median $89.13 Typical High $107.15 | Facility | None | $48.98 | $89.13 | $107.15 |
Medcost Setting Professional Modifier None Typical Low $61.66 Median $83.18 Typical High $204.17 | Professional | None | $61.66 | $83.18 | $204.17 |
Sentara Setting Facility Modifier None Typical Low $79.43 Median $114.82 Typical High $354.81 | Facility | None | $79.43 | $114.82 | $354.81 |
Sentara Setting Professional Modifier None Typical Low $89.13 Median $120.23 Typical High $245.47 | Professional | None | $89.13 | $120.23 | $245.47 |
United Setting Facility Modifier None Typical Low $93.33 Median $114.82 Typical High $190.55 | Facility | None | $93.33 | $114.82 | $190.55 |
United Setting Professional Modifier None Typical Low $69.18 Median $79.43 Typical High $120.23 | Professional | None | $69.18 | $79.43 | $120.23 |
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 $33.11 Median $39.81 Typical High $39.81 | Professional | 52 · Reduced service | $33.11 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $15.85 Typical High $15.85 | Professional | 53 · Discontinued | $13.18 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $12.02 Typical High $12.02 | Professional | 55 · Aftercare only | $10.00 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $7.94 Typical High $7.94 | Professional | 56 · Pre-op care only | $6.61 | $7.94 | $7.94 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $8.71 Median $8.71 Typical High $10.96 | Professional | RR · Rental | $8.71 | $8.71 | $10.96 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $63.10 Median $64.57 Typical High $64.57 | Professional | UE · Used equipment | $63.10 | $64.57 | $64.57 |
Where Virginia sits
The same service costs 5.1 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· 29th of 51
$87.10
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.