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 $30.90 Median $37.15 Typical High $37.15 | Facility | None | $30.90 | $37.15 | $37.15 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $37.15 Typical High $37.15 | Professional | None | $30.90 | $37.15 | $37.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $81.28 | Facility | None | $75.86 | $75.86 | $81.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $44.67 | Professional | None | $39.81 | $39.81 | $44.67 |
CareFirst Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $52.48 | Professional | None | $39.81 | $39.81 | $52.48 |
Cigna Setting Facility Modifier None Typical Low $35.48 Median $56.23 Typical High $56.23 | Facility | None | $35.48 | $56.23 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $56.23 | Professional | None | $40.74 | $40.74 | $56.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $53.70 Median $75.86 Typical High $100.00 | Professional | None | $53.70 | $75.86 | $100.00 |
Medcost Setting Professional Modifier None Typical Low $44.67 Median $50.12 Typical High $70.79 | Professional | None | $44.67 | $50.12 | $70.79 |
Medcost Setting Facility Modifier None Typical Low $23.44 Median $40.74 Typical High $50.12 | Facility | None | $23.44 | $40.74 | $50.12 |
Medcost Setting Professional Modifier None Typical Low $32.36 Median $40.74 Typical High $95.50 | Professional | None | $32.36 | $40.74 | $95.50 |
Sentara Setting Facility Modifier None Typical Low $37.15 Median $53.70 Typical High $165.96 | Facility | None | $37.15 | $53.70 | $165.96 |
Sentara Setting Professional Modifier None Typical Low $40.74 Median $56.23 Typical High $114.82 | Professional | None | $40.74 | $56.23 | $114.82 |
United Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $107.15 | Facility | None | $43.65 | $43.65 | $107.15 |
United Setting Professional Modifier None Typical Low $33.11 Median $37.15 Typical High $56.23 | Professional | None | $33.11 | $37.15 | $56.23 |
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 $15.49 Median $18.62 Typical High $18.62 | Professional | 52 · Reduced service | $15.49 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $7.41 Typical High $7.41 | Professional | 53 · Discontinued | $6.17 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $5.62 Typical High $5.62 | Professional | 55 · Aftercare only | $4.57 | $5.62 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.72 Typical High $3.72 | Professional | 56 · Pre-op care only | $3.09 | $3.72 | $3.72 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.07 Median $4.07 Typical High $5.37 | Professional | RR · Rental | $4.07 | $4.07 | $5.37 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $29.51 Median $30.90 Typical High $30.90 | Professional | UE · Used equipment | $29.51 | $30.90 | $30.90 |
Where Virginia sits
The same service costs 3.1 times more in Hawaii than in Kentucky. 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· 47th of 51
$40.74
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.