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 $43.65 Median $52.48 Typical High $52.48 | Facility | None | $43.65 | $52.48 | $52.48 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $52.48 Typical High $56.23 | Professional | None | $43.65 | $52.48 | $56.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $114.82 | Facility | None | $107.15 | $107.15 | $114.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $72.44 | Professional | None | $64.57 | $64.57 | $72.44 |
CareFirst Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $74.13 | Professional | None | $57.54 | $57.54 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $69.18 Typical High $69.18 | Facility | None | $56.23 | $69.18 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $69.18 | Professional | None | $50.12 | $50.12 | $69.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $75.86 Median $107.15 Typical High $141.25 | Professional | None | $75.86 | $107.15 | $141.25 |
Medcost Setting Professional Modifier None Typical Low $63.10 Median $70.79 Typical High $100.00 | Professional | None | $63.10 | $70.79 | $100.00 |
Medcost Setting Facility Modifier None Typical Low $37.15 Median $57.54 Typical High $70.79 | Facility | None | $37.15 | $57.54 | $70.79 |
Medcost Setting Professional Modifier None Typical Low $57.54 Median $60.26 Typical High $134.90 | Professional | None | $57.54 | $60.26 | $134.90 |
Sentara Setting Facility Modifier None Typical Low $52.48 Median $74.13 Typical High $234.42 | Facility | None | $52.48 | $74.13 | $234.42 |
Sentara Setting Professional Modifier None Typical Low $57.54 Median $79.43 Typical High $162.18 | Professional | None | $57.54 | $79.43 | $162.18 |
United Setting Facility Modifier None Typical Low $70.79 Median $83.18 Typical High $144.54 | Facility | None | $70.79 | $83.18 | $144.54 |
United Setting Professional Modifier None Typical Low $47.86 Median $52.48 Typical High $79.43 | Professional | None | $47.86 | $52.48 | $79.43 |
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 $21.88 Median $26.30 Typical High $26.30 | Professional | 52 · Reduced service | $21.88 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $10.47 Typical High $10.47 | Professional | 53 · Discontinued | $8.71 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $7.76 Typical High $7.76 | Professional | 55 · Aftercare only | $6.46 | $7.76 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $5.25 Typical High $5.25 | Professional | 56 · Pre-op care only | $4.37 | $5.25 | $5.25 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.61 Median $6.61 Typical High $8.51 | Professional | RR · Rental | $6.61 | $6.61 | $8.51 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $47.86 Median $48.98 Typical High $52.48 | Professional | UE · Used equipment | $47.86 | $48.98 | $52.48 |
Where Virginia sits
The same service costs 4.4 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· 35th of 51
$64.57
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.