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 $39.81 Median $47.86 Typical High $47.86 | Facility | None | $39.81 | $47.86 | $47.86 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $47.86 Typical High $63.10 | Professional | None | $39.81 | $47.86 | $63.10 |
Anthem BCBS Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $107.15 | Facility | None | $100.00 | $100.00 | $107.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $67.61 | Professional | None | $58.88 | $58.88 | $67.61 |
CareFirst Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $69.18 | Professional | None | $52.48 | $52.48 | $69.18 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $72.44 Typical High $72.44 | Facility | None | $52.48 | $72.44 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $72.44 | Professional | None | $52.48 | $52.48 | $72.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $69.18 Median $100.00 Typical High $128.82 | Professional | None | $69.18 | $100.00 | $128.82 |
Medcost Setting Professional Modifier None Typical Low $58.88 Median $66.07 Typical High $91.20 | Professional | None | $58.88 | $66.07 | $91.20 |
Medcost Setting Facility Modifier None Typical Low $34.67 Median $53.70 Typical High $64.57 | Facility | None | $34.67 | $53.70 | $64.57 |
Medcost Setting Professional Modifier None Typical Low $50.12 Median $54.95 Typical High $125.89 | Professional | None | $50.12 | $54.95 | $125.89 |
Sentara Setting Facility Modifier None Typical Low $48.98 Median $72.44 Typical High $213.80 | Facility | None | $48.98 | $72.44 | $213.80 |
Sentara Setting Professional Modifier None Typical Low $53.70 Median $74.13 Typical High $151.36 | Professional | None | $53.70 | $74.13 | $151.36 |
United Setting Facility Modifier None Typical Low $64.57 Median $100.00 Typical High $131.83 | Facility | None | $64.57 | $100.00 | $131.83 |
United Setting Professional Modifier None Typical Low $43.65 Median $48.98 Typical High $74.13 | Professional | None | $43.65 | $48.98 | $74.13 |
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 $19.95 Median $23.99 Typical High $23.99 | Professional | 52 · Reduced service | $19.95 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $9.77 Typical High $9.77 | Professional | 53 · Discontinued | $7.94 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $7.24 Typical High $7.24 | Professional | 55 · Aftercare only | $6.03 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $4.79 Typical High $4.79 | Professional | 56 · Pre-op care only | $3.98 | $4.79 | $4.79 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.03 Median $6.03 Typical High $7.76 | Professional | RR · Rental | $6.03 | $6.03 | $7.76 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $44.67 Median $45.71 Typical High $47.86 | Professional | UE · Used equipment | $44.67 | $45.71 | $47.86 |
Where Virginia sits
The same service costs 5.0 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· 39th of 51
$58.88
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.