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 $77.62 Median $93.33 Typical High $93.33 | Facility | None | $77.62 | $93.33 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $93.33 Typical High $93.33 | Professional | None | $77.62 | $93.33 | $93.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $204.17 | Facility | None | $194.98 | $194.98 | $204.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $128.82 | Professional | None | $114.82 | $114.82 | $128.82 |
CareFirst Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $131.83 | Professional | None | $107.15 | $107.15 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $128.82 Typical High $128.82 | Facility | None | $87.10 | $128.82 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $128.82 | Professional | None | $95.50 | $95.50 | $128.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $134.90 Median $194.98 Typical High $251.19 | Professional | None | $134.90 | $194.98 | $251.19 |
Medcost Setting Professional Modifier None Typical Low $97.72 Median $125.89 Typical High $177.83 | Professional | None | $97.72 | $125.89 | $177.83 |
Medcost Setting Facility Modifier None Typical Low $61.66 Median $104.71 Typical High $125.89 | Facility | None | $61.66 | $104.71 | $125.89 |
Medcost Setting Professional Modifier None Typical Low $104.71 Median $125.89 Typical High $251.19 | Professional | None | $104.71 | $125.89 | $251.19 |
Sentara Setting Facility Modifier None Typical Low $81.28 Median $134.90 Typical High $416.87 | Facility | None | $81.28 | $134.90 | $416.87 |
Sentara Setting Professional Modifier None Typical Low $89.13 Median $141.25 Typical High $295.12 | Professional | None | $89.13 | $141.25 | $295.12 |
United Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $281.84 | Facility | None | $234.42 | $234.42 | $281.84 |
United Setting Professional Modifier None Typical Low $85.11 Median $95.50 Typical High $141.25 | Professional | None | $85.11 | $95.50 | $141.25 |
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 $38.90 Median $46.77 Typical High $46.77 | Professional | 52 · Reduced service | $38.90 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $18.62 Typical High $18.62 | Professional | 53 · Discontinued | $15.49 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $14.13 Typical High $14.13 | Professional | 55 · Aftercare only | $11.75 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $9.33 Typical High $9.33 | Professional | 56 · Pre-op care only | $7.76 | $9.33 | $9.33 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $11.75 Median $11.75 Typical High $13.80 | Professional | RR · Rental | $11.75 | $11.75 | $13.80 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $85.11 Median $87.10 Typical High $91.20 | Professional | UE · Used equipment | $85.11 | $87.10 | $91.20 |
Where Virginia sits
The same service costs 2.5 times more in Kansas than in Utah. 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· 30th of 51
$115
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.