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 $41.69 Median $50.12 Typical High $50.12 | Facility | None | $41.69 | $50.12 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $50.12 Typical High $50.12 | Professional | None | $41.69 | $50.12 | $50.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $112.20 | Facility | None | $104.71 | $104.71 | $112.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $64.57 | Professional | None | $56.23 | $56.23 | $64.57 |
CareFirst Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $72.44 | Professional | None | $53.70 | $53.70 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $67.61 Typical High $67.61 | Facility | None | $54.95 | $67.61 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $67.61 | Professional | None | $50.12 | $50.12 | $67.61 |
Kaiser Permanente Setting Professional Modifier None Typical Low $72.44 Median $104.71 Typical High $134.90 | Professional | None | $72.44 | $104.71 | $134.90 |
Medcost Setting Professional Modifier None Typical Low $61.66 Median $69.18 Typical High $95.50 | Professional | None | $61.66 | $69.18 | $95.50 |
Medcost Setting Facility Modifier None Typical Low $33.11 Median $56.23 Typical High $67.61 | Facility | None | $33.11 | $56.23 | $67.61 |
Medcost Setting Professional Modifier None Typical Low $28.18 Median $38.02 Typical High $131.83 | Professional | None | $28.18 | $38.02 | $131.83 |
Sentara Setting Facility Modifier None Typical Low $42.66 Median $72.44 Typical High $223.87 | Facility | None | $42.66 | $72.44 | $223.87 |
Sentara Setting Professional Modifier None Typical Low $43.65 Median $77.62 Typical High $158.49 | Professional | None | $43.65 | $77.62 | $158.49 |
United Setting Facility Modifier None Typical Low $32.36 Median $60.26 Typical High $128.82 | Facility | None | $32.36 | $60.26 | $128.82 |
United Setting Professional Modifier None Typical Low $45.71 Median $51.29 Typical High $77.62 | Professional | None | $45.71 | $51.29 | $77.62 |
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 $20.89 Median $25.12 Typical High $25.12 | Professional | 52 · Reduced service | $20.89 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $10.23 Typical High $10.23 | Professional | 53 · Discontinued | $8.32 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $7.59 Typical High $7.59 | Professional | 55 · Aftercare only | $6.31 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $5.13 Typical High $5.13 | Professional | 56 · Pre-op care only | $4.17 | $5.13 | $5.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.89 Median $5.89 Typical High $7.41 | Professional | RR · Rental | $5.89 | $5.89 | $7.41 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $42.66 Median $43.65 Typical High $43.65 | Professional | UE · Used equipment | $42.66 | $43.65 | $43.65 |
Where Virginia sits
The same service costs 2.1 times more in Montana 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
$56.23
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.