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 $18.20 Median $22.39 Typical High $22.39 | Facility | None | $18.20 | $22.39 | $22.39 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $22.39 Typical High $22.39 | Professional | None | $18.20 | $22.39 | $22.39 |
Anthem BCBS Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
CareFirst Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $50.12 | Professional | None | $47.86 | $47.86 | $50.12 |
Cigna Setting Facility Modifier None Typical Low $20.42 Median $30.20 Typical High $30.20 | Facility | None | $20.42 | $30.20 | $30.20 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $30.20 | Professional | None | $21.88 | $21.88 | $30.20 |
Kaiser Permanente Setting Professional Modifier None Typical Low $33.11 Median $40.74 Typical High $53.70 | Professional | None | $33.11 | $40.74 | $53.70 |
Medcost Setting Facility Modifier None Typical Low $19.05 Median $25.70 Typical High $30.90 | Facility | None | $19.05 | $25.70 | $30.90 |
Medcost Setting Professional Modifier None Typical Low $25.70 Median $40.74 Typical High $134.90 | Professional | None | $25.70 | $40.74 | $134.90 |
Sentara Setting Facility Modifier None Typical Low $23.99 Median $37.15 Typical High $97.72 | Facility | None | $23.99 | $37.15 | $97.72 |
Sentara Setting Professional Modifier None Typical Low $24.55 Median $38.02 Typical High $69.18 | Professional | None | $24.55 | $38.02 | $69.18 |
United Setting Professional Modifier None Typical Low $21.38 Median $25.70 Typical High $51.29 | Professional | None | $21.38 | $25.70 | $51.29 |
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 $9.12 Median $10.96 Typical High $10.96 | Professional | 52 · Reduced service | $9.12 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $4.47 Typical High $4.47 | Professional | 53 · Discontinued | $3.72 | $4.47 | $4.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $3.31 Typical High $3.31 | Professional | 55 · Aftercare only | $2.75 | $3.31 | $3.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $2.24 Typical High $2.24 | Professional | 56 · Pre-op care only | $1.82 | $2.24 | $2.24 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | RR · Rental | $5.01 | $5.01 | $5.01 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | UE · Used equipment | $38.02 | $38.02 | $38.02 |
Where Virginia sits
The same service costs 6.5 times more in Kansas than in Hawaii. 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· 12th of 51
$42.66
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.