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 $19.50 Median $23.44 Typical High $23.44 | Facility | None | $19.50 | $23.44 | $23.44 |
Aetna Setting Professional Modifier None Typical Low $19.50 Median $23.44 Typical High $23.44 | Professional | None | $19.50 | $23.44 | $23.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $51.29 | Facility | None | $48.98 | $48.98 | $51.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $30.20 | Professional | None | $26.92 | $26.92 | $30.20 |
CareFirst Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $33.88 | Professional | None | $25.12 | $25.12 | $33.88 |
Cigna Setting Facility Modifier None Typical Low $21.88 Median $27.54 Typical High $27.54 | Facility | None | $21.88 | $27.54 | $27.54 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $27.54 | Professional | None | $19.95 | $19.95 | $27.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $33.88 Median $48.98 Typical High $63.10 | Professional | None | $33.88 | $48.98 | $63.10 |
Medcost Setting Professional Modifier None Typical Low $24.55 Median $32.36 Typical High $44.67 | Professional | None | $24.55 | $32.36 | $44.67 |
Medcost Setting Facility Modifier None Typical Low $15.49 Median $26.30 Typical High $31.62 | Facility | None | $15.49 | $26.30 | $31.62 |
Medcost Setting Professional Modifier None Typical Low $26.30 Median $29.51 Typical High $61.66 | Professional | None | $26.30 | $29.51 | $61.66 |
Sentara Setting Facility Modifier None Typical Low $19.95 Median $33.88 Typical High $104.71 | Facility | None | $19.95 | $33.88 | $104.71 |
Sentara Setting Professional Modifier None Typical Low $12.02 Median $36.31 Typical High $74.13 | Professional | None | $12.02 | $36.31 | $74.13 |
United Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $70.79 | Facility | None | $60.26 | $60.26 | $70.79 |
United Setting Professional Modifier None Typical Low $21.38 Median $23.99 Typical High $36.31 | Professional | None | $21.38 | $23.99 | $36.31 |
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 $9.77 Median $11.75 Typical High $11.75 | Professional | 52 · Reduced service | $9.77 | $11.75 | $11.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.89 Median $4.68 Typical High $4.68 | Professional | 53 · Discontinued | $3.89 | $4.68 | $4.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.95 Median $3.55 Typical High $3.55 | Professional | 55 · Aftercare only | $2.95 | $3.55 | $3.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $2.34 Typical High $2.34 | Professional | 56 · Pre-op care only | $1.95 | $2.34 | $2.34 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.75 Median $2.75 Typical High $3.47 | Professional | RR · Rental | $2.75 | $2.75 | $3.47 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $19.95 Median $20.42 Typical High $21.88 | Professional | UE · Used equipment | $19.95 | $20.42 | $21.88 |
Where Virginia sits
The same service costs 2.6 times more in Montana than in Delaware. 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· 32nd of 51
$26.92
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.