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 $20.89 Median $25.12 Typical High $25.12 | Facility | None | $20.89 | $25.12 | $25.12 |
Aetna Setting Professional Modifier None Typical Low $20.89 Median $25.12 Typical High $25.70 | Professional | None | $20.89 | $25.12 | $25.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $54.95 | Facility | None | $51.29 | $51.29 | $54.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $33.88 | Professional | None | $27.54 | $27.54 | $33.88 |
CareFirst Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $35.48 | Professional | None | $26.92 | $26.92 | $35.48 |
Cigna Setting Facility Modifier None Typical Low $23.44 Median $34.67 Typical High $34.67 | Facility | None | $23.44 | $34.67 | $34.67 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $34.67 | Professional | None | $25.70 | $25.70 | $34.67 |
Kaiser Permanente Setting Professional Modifier None Typical Low $36.31 Median $51.29 Typical High $67.61 | Professional | None | $36.31 | $51.29 | $67.61 |
Medcost Setting Professional Modifier None Typical Low $26.30 Median $33.88 Typical High $47.86 | Professional | None | $26.30 | $33.88 | $47.86 |
Medcost Setting Facility Modifier None Typical Low $16.60 Median $27.54 Typical High $33.88 | Facility | None | $16.60 | $27.54 | $33.88 |
Medcost Setting Professional Modifier None Typical Low $27.54 Median $31.62 Typical High $64.57 | Professional | None | $27.54 | $31.62 | $64.57 |
Sentara Setting Facility Modifier None Typical Low $21.38 Median $36.31 Typical High $112.20 | Facility | None | $21.38 | $36.31 | $112.20 |
Sentara Setting Professional Modifier None Typical Low $19.50 Median $38.02 Typical High $77.62 | Professional | None | $19.50 | $38.02 | $77.62 |
United Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $75.86 | Facility | None | $63.10 | $63.10 | $75.86 |
United Setting Professional Modifier None Typical Low $22.91 Median $25.12 Typical High $38.02 | Professional | None | $22.91 | $25.12 | $38.02 |
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 $10.47 Median $12.59 Typical High $12.59 | Professional | 52 · Reduced service | $10.47 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $5.01 Typical High $5.01 | Professional | 53 · Discontinued | $4.17 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.09 Median $3.80 Typical High $3.80 | Professional | 55 · Aftercare only | $3.09 | $3.80 | $3.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.51 Typical High $2.51 | Professional | 56 · Pre-op care only | $2.09 | $2.51 | $2.51 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.75 Median $2.75 Typical High $3.72 | Professional | RR · Rental | $2.75 | $2.75 | $3.72 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $20.42 Median $20.42 Typical High $21.88 | Professional | UE · Used equipment | $20.42 | $20.42 | $21.88 |
Where Virginia sits
The same service costs 2.1 times more in Montana than in New Jersey. 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· 40th of 51
$27.54
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.