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 $15.14 Median $18.62 Typical High $18.62 | Facility | None | $15.14 | $18.62 | $18.62 |
Aetna Setting Professional Modifier None Typical Low $15.14 Median $18.62 Typical High $18.62 | Professional | None | $15.14 | $18.62 | $18.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $40.74 | Facility | None | $38.02 | $38.02 | $40.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $25.70 | Professional | None | $20.89 | $20.89 | $25.70 |
CareFirst Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $26.30 | Professional | None | $19.95 | $19.95 | $26.30 |
Cigna Setting Facility Modifier None Typical Low $16.98 Median $21.38 Typical High $21.38 | Facility | None | $16.98 | $21.38 | $21.38 |
Cigna Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $21.38 | Professional | None | $15.49 | $15.49 | $21.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $26.92 Median $38.02 Typical High $48.98 | Professional | None | $26.92 | $38.02 | $48.98 |
Medcost Setting Professional Modifier None Typical Low $19.50 Median $25.12 Typical High $34.67 | Professional | None | $19.50 | $25.12 | $34.67 |
Medcost Setting Facility Modifier None Typical Low $12.02 Median $20.42 Typical High $25.12 | Facility | None | $12.02 | $20.42 | $25.12 |
Medcost Setting Professional Modifier None Typical Low $20.42 Median $22.91 Typical High $47.86 | Professional | None | $20.42 | $22.91 | $47.86 |
Sentara Setting Facility Modifier None Typical Low $15.49 Median $26.30 Typical High $81.28 | Facility | None | $15.49 | $26.30 | $81.28 |
Sentara Setting Professional Modifier None Typical Low $16.60 Median $28.18 Typical High $57.54 | Professional | None | $16.60 | $28.18 | $57.54 |
United Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $56.23 | Facility | None | $46.77 | $46.77 | $56.23 |
United Setting Professional Modifier None Typical Low $16.98 Median $18.62 Typical High $28.18 | Professional | None | $16.98 | $18.62 | $28.18 |
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 $7.59 Median $9.33 Typical High $9.33 | Professional | 52 · Reduced service | $7.59 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.09 Median $3.72 Typical High $3.72 | Professional | 53 · Discontinued | $3.09 | $3.72 | $3.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.29 Median $2.75 Typical High $2.75 | Professional | 55 · Aftercare only | $2.29 | $2.75 | $2.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.51 Median $1.86 Typical High $1.86 | Professional | 56 · Pre-op care only | $1.51 | $1.86 | $1.86 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.04 Median $2.04 Typical High $2.69 | Professional | RR · Rental | $2.04 | $2.04 | $2.69 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $15.49 Median $15.49 Typical High $16.98 | Professional | UE · Used equipment | $15.49 | $15.49 | $16.98 |
Where Virginia sits
The same service costs 3.1 times more in Montana than in Kansas. 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
$20.89
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.