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 $47.86 Median $57.54 Typical High $57.54 | Facility | None | $47.86 | $57.54 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $57.54 Typical High $57.54 | Professional | None | $47.86 | $57.54 | $57.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $125.89 | Facility | None | $120.23 | $120.23 | $125.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $61.66 | Professional | None | $53.70 | $53.70 | $61.66 |
CareFirst Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $81.28 | Professional | None | $63.10 | $63.10 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $66.07 Typical High $66.07 | Facility | None | $63.10 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $66.07 | Professional | None | $47.86 | $47.86 | $66.07 |
Kaiser Permanente Setting Professional Modifier None Typical Low $83.18 Median $120.23 Typical High $154.88 | Professional | None | $83.18 | $120.23 | $154.88 |
Medcost Setting Professional Modifier None Typical Low $70.79 Median $77.62 Typical High $109.65 | Professional | None | $70.79 | $77.62 | $109.65 |
Medcost Setting Facility Modifier None Typical Low $30.90 Median $64.57 Typical High $77.62 | Facility | None | $30.90 | $64.57 | $77.62 |
Medcost Setting Professional Modifier None Typical Low $38.90 Median $48.98 Typical High $147.91 | Professional | None | $38.90 | $48.98 | $147.91 |
Sentara Setting Facility Modifier None Typical Low $58.88 Median $83.18 Typical High $257.04 | Facility | None | $58.88 | $83.18 | $257.04 |
Sentara Setting Professional Modifier None Typical Low $64.57 Median $87.10 Typical High $181.97 | Professional | None | $64.57 | $87.10 | $181.97 |
United Setting Facility Modifier None Typical Low $58.88 Median $60.26 Typical High $120.23 | Facility | None | $58.88 | $60.26 | $120.23 |
United Setting Professional Modifier None Typical Low $43.65 Median $58.88 Typical High $89.13 | Professional | None | $43.65 | $58.88 | $89.13 |
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 $23.99 Median $28.84 Typical High $28.84 | Professional | 52 · Reduced service | $23.99 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $11.48 Typical High $11.48 | Professional | 53 · Discontinued | $9.55 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $8.71 Typical High $8.71 | Professional | 55 · Aftercare only | $7.24 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $5.75 Typical High $5.75 | Professional | 56 · Pre-op care only | $4.79 | $5.75 | $5.75 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.50 Median $5.50 Typical High $7.08 | Professional | RR · Rental | $5.50 | $5.50 | $7.08 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $39.81 Median $41.69 Typical High $41.69 | Professional | UE · Used equipment | $39.81 | $41.69 | $41.69 |
Where Virginia sits
The same service costs 3.6 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· 31st of 51
$57.54
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.