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 $26.92 Median $32.36 Typical High $32.36 | Facility | None | $26.92 | $32.36 | $32.36 |
Aetna Setting Professional Modifier None Typical Low $26.92 Median $32.36 Typical High $32.36 | Professional | None | $26.92 | $32.36 | $32.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $42.66 Median $61.66 Typical High $83.18 | Professional | None | $42.66 | $61.66 | $83.18 |
CareFirst Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $50.12 Typical High $50.12 | Facility | None | $33.11 | $50.12 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $50.12 | Professional | None | $36.31 | $36.31 | $50.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $47.86 Median $60.26 Typical High $77.62 | Professional | None | $47.86 | $60.26 | $77.62 |
Medcost Setting Facility Modifier None Typical Low $27.54 Median $37.15 Typical High $45.71 | Facility | None | $27.54 | $37.15 | $45.71 |
Medcost Setting Professional Modifier None Typical Low $37.15 Median $45.71 Typical High $58.88 | Professional | None | $37.15 | $45.71 | $58.88 |
Sentara Setting Facility Modifier None Typical Low $34.67 Median $54.95 Typical High $144.54 | Facility | None | $34.67 | $54.95 | $144.54 |
Sentara Setting Professional Modifier None Typical Low $35.48 Median $54.95 Typical High $100.00 | Professional | None | $35.48 | $54.95 | $100.00 |
United Setting Professional Modifier None Typical Low $30.90 Median $38.02 Typical High $75.86 | Professional | None | $30.90 | $38.02 | $75.86 |
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 $13.49 Median $16.22 Typical High $16.22 | Professional | 52 · Reduced service | $13.49 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.37 Median $6.46 Typical High $6.46 | Professional | 53 · Discontinued | $5.37 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $4.90 Typical High $4.90 | Professional | 55 · Aftercare only | $4.07 | $4.90 | $4.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $3.24 Typical High $3.24 | Professional | 56 · Pre-op care only | $2.69 | $3.24 | $3.24 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.01 Median $5.01 Typical High $5.37 | Professional | RR · Rental | $5.01 | $5.01 | $5.37 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | UE · Used equipment | $37.15 | $37.15 | $37.15 |
Where Virginia sits
The same service costs 4.1 times more in Kansas than in Colorado. 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
$43.65
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.