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 $31.62 Median $38.02 Typical High $38.02 | Facility | None | $31.62 | $38.02 | $38.02 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $38.02 Typical High $38.02 | Professional | None | $31.62 | $38.02 | $38.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $83.18 | Facility | None | $77.62 | $77.62 | $83.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $56.23 | Professional | None | $45.71 | $45.71 | $56.23 |
CareFirst Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $53.70 | Professional | None | $40.74 | $40.74 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $38.02 Median $54.95 Typical High $54.95 | Facility | None | $38.02 | $54.95 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $54.95 | Professional | None | $39.81 | $39.81 | $54.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $54.95 Median $77.62 Typical High $102.33 | Professional | None | $54.95 | $77.62 | $102.33 |
Medcost Setting Professional Modifier None Typical Low $46.77 Median $51.29 Typical High $72.44 | Professional | None | $46.77 | $51.29 | $72.44 |
Medcost Setting Facility Modifier None Typical Low $26.92 Median $41.69 Typical High $51.29 | Facility | None | $26.92 | $41.69 | $51.29 |
Medcost Setting Professional Modifier None Typical Low $36.31 Median $42.66 Typical High $97.72 | Professional | None | $36.31 | $42.66 | $97.72 |
Sentara Setting Facility Modifier None Typical Low $38.02 Median $54.95 Typical High $169.82 | Facility | None | $38.02 | $54.95 | $169.82 |
Sentara Setting Professional Modifier None Typical Low $41.69 Median $58.88 Typical High $117.49 | Professional | None | $41.69 | $58.88 | $117.49 |
United Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $123.03 | Facility | None | $51.29 | $51.29 | $123.03 |
United Setting Professional Modifier None Typical Low $34.67 Median $38.02 Typical High $57.54 | Professional | None | $34.67 | $38.02 | $57.54 |
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 $15.85 Median $19.05 Typical High $19.05 | Professional | 52 · Reduced service | $15.85 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $7.59 Typical High $7.59 | Professional | 53 · Discontinued | $6.31 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $5.75 Typical High $5.75 | Professional | 55 · Aftercare only | $4.68 | $5.75 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.80 Typical High $3.80 | Professional | 56 · Pre-op care only | $3.16 | $3.80 | $3.80 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.57 Median $4.57 Typical High $6.17 | Professional | RR · Rental | $4.57 | $4.57 | $6.17 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | UE · Used equipment | $33.88 | $33.88 | $33.88 |
Where Virginia sits
The same service costs 3.5 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· 37th of 51
$45.71
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.