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 $24.55 Median $29.51 Typical High $29.51 | Facility | None | $24.55 | $29.51 | $29.51 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $29.51 Typical High $70.79 | Professional | None | $24.55 | $29.51 | $70.79 |
Anthem BCBS Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $64.57 | Facility | None | $61.66 | $61.66 | $64.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $45.71 | Professional | None | $34.67 | $34.67 | $45.71 |
CareFirst Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $41.69 | Professional | None | $33.11 | $33.11 | $41.69 |
Cigna Setting Facility Modifier None Typical Low $27.54 Median $33.88 Typical High $36.31 | Facility | None | $27.54 | $33.88 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $33.88 | Professional | None | $25.12 | $25.12 | $33.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $42.66 Median $61.66 Typical High $79.43 | Professional | None | $42.66 | $61.66 | $79.43 |
Medcost Setting Professional Modifier None Typical Low $30.90 Median $39.81 Typical High $56.23 | Professional | None | $30.90 | $39.81 | $56.23 |
Medcost Setting Facility Modifier None Typical Low $19.50 Median $33.11 Typical High $39.81 | Facility | None | $19.50 | $33.11 | $39.81 |
Medcost Setting Professional Modifier None Typical Low $6.03 Median $36.31 Typical High $75.86 | Professional | None | $6.03 | $36.31 | $75.86 |
Sentara Setting Facility Modifier None Typical Low $25.12 Median $42.66 Typical High $131.83 | Facility | None | $25.12 | $42.66 | $131.83 |
Sentara Setting Professional Modifier None Typical Low $24.55 Median $44.67 Typical High $91.20 | Professional | None | $24.55 | $44.67 | $91.20 |
United Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $89.13 | Facility | None | $74.13 | $74.13 | $89.13 |
United Setting Professional Modifier None Typical Low $26.92 Median $30.20 Typical High $44.67 | Professional | None | $26.92 | $30.20 | $44.67 |
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 $12.30 Median $14.79 Typical High $14.79 | Professional | 52 · Reduced service | $12.30 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $5.89 Typical High $5.89 | Professional | 53 · Discontinued | $4.90 | $5.89 | $5.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $4.47 Typical High $4.47 | Professional | 55 · Aftercare only | $3.63 | $4.47 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.95 Typical High $2.95 | Professional | 56 · Pre-op care only | $2.45 | $2.95 | $2.95 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.47 Median $3.47 Typical High $4.37 | Professional | RR · Rental | $3.47 | $3.47 | $4.37 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $25.12 Median $25.70 Typical High $26.92 | Professional | UE · Used equipment | $25.12 | $25.70 | $26.92 |
Where Virginia sits
The same service costs 2.8 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· 27th of 51
$34.67
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.