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 $64.57 Median $79.43 Typical High $79.43 | Facility | None | $64.57 | $79.43 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $79.43 Typical High $79.43 | Professional | None | $64.57 | $79.43 | $79.43 |
Anthem BCBS Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $173.78 | Facility | None | $162.18 | $162.18 | $173.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $93.33 | Professional | None | $75.86 | $75.86 | $93.33 |
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 $64.57 Median $104.71 Typical High $104.71 | Facility | None | $64.57 | $104.71 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $104.71 | Professional | None | $75.86 | $75.86 | $104.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $114.82 Median $162.18 Typical High $213.80 | Professional | None | $114.82 | $162.18 | $213.80 |
Medcost Setting Professional Modifier None Typical Low $95.50 Median $107.15 Typical High $147.91 | Professional | None | $95.50 | $107.15 | $147.91 |
Medcost Setting Facility Modifier None Typical Low $44.67 Median $87.10 Typical High $107.15 | Facility | None | $44.67 | $87.10 | $107.15 |
Medcost Setting Professional Modifier None Typical Low $56.23 Median $75.86 Typical High $204.17 | Professional | None | $56.23 | $75.86 | $204.17 |
Sentara Setting Facility Modifier None Typical Low $79.43 Median $112.20 Typical High $346.74 | Facility | None | $79.43 | $112.20 | $346.74 |
Sentara Setting Professional Modifier None Typical Low $87.10 Median $120.23 Typical High $245.47 | Professional | None | $87.10 | $120.23 | $245.47 |
United Setting Facility Modifier None Typical Low $75.86 Median $85.11 Typical High $173.78 | Facility | None | $75.86 | $85.11 | $173.78 |
United Setting Professional Modifier None Typical Low $63.10 Median $79.43 Typical High $120.23 | Professional | None | $63.10 | $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 $32.36 Median $39.81 Typical High $39.81 | Professional | 52 · Reduced service | $32.36 | $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 $9.77 Median $11.75 Typical High $11.75 | Professional | 55 · Aftercare only | $9.77 | $11.75 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $7.94 Typical High $7.94 | Professional | 56 · Pre-op care only | $6.46 | $7.94 | $7.94 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $7.59 Median $7.59 Typical High $10.23 | Professional | RR · Rental | $7.59 | $7.59 | $10.23 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $57.54 Median $57.54 Typical High $61.66 | Professional | UE · Used equipment | $57.54 | $57.54 | $61.66 |
Where Virginia sits
The same service costs 3.0 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· 33rd 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.