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 $38.90 Median $47.86 Typical High $47.86 | Facility | None | $38.90 | $47.86 | $47.86 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $47.86 Typical High $47.86 | Professional | None | $38.90 | $47.86 | $47.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $104.71 | Facility | None | $97.72 | $97.72 | $104.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $60.26 | Professional | None | $52.48 | $52.48 | $60.26 |
CareFirst Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $67.61 | Professional | None | $53.70 | $53.70 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $44.67 Median $70.79 Typical High $70.79 | Facility | None | $44.67 | $70.79 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $70.79 | Professional | None | $51.29 | $51.29 | $70.79 |
Kaiser Permanente Setting Professional Modifier None Typical Low $67.61 Median $97.72 Typical High $125.89 | Professional | None | $67.61 | $97.72 | $125.89 |
Medcost Setting Professional Modifier None Typical Low $48.98 Median $64.57 Typical High $89.13 | Professional | None | $48.98 | $64.57 | $89.13 |
Medcost Setting Facility Modifier None Typical Low $30.90 Median $52.48 Typical High $63.10 | Facility | None | $30.90 | $52.48 | $63.10 |
Medcost Setting Professional Modifier None Typical Low $52.48 Median $57.54 Typical High $123.03 | Professional | None | $52.48 | $57.54 | $123.03 |
Sentara Setting Facility Modifier None Typical Low $40.74 Median $67.61 Typical High $208.93 | Facility | None | $40.74 | $67.61 | $208.93 |
Sentara Setting Professional Modifier None Typical Low $44.67 Median $72.44 Typical High $147.91 | Professional | None | $44.67 | $72.44 | $147.91 |
United Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $144.54 | Facility | None | $120.23 | $120.23 | $144.54 |
United Setting Professional Modifier None Typical Low $43.65 Median $47.86 Typical High $72.44 | Professional | None | $43.65 | $47.86 | $72.44 |
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 $19.50 Median $23.44 Typical High $23.44 | Professional | 52 · Reduced service | $19.50 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $9.55 Typical High $9.55 | Professional | 53 · Discontinued | $7.76 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $7.08 Typical High $7.08 | Professional | 55 · Aftercare only | $5.89 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $4.68 Typical High $4.68 | Professional | 56 · Pre-op care only | $3.89 | $4.68 | $4.68 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.37 Median $5.37 Typical High $6.92 | Professional | RR · Rental | $5.37 | $5.37 | $6.92 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $39.81 Median $40.74 Typical High $42.66 | Professional | UE · Used equipment | $39.81 | $40.74 | $42.66 |
Where Virginia sits
The same service costs 2.0 times more in Hawaii than in West Virginia. 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· 42nd of 51
$52.48
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.