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 $15.85 Median $19.05 Typical High $19.05 | Facility | None | $15.85 | $19.05 | $19.05 |
Aetna Setting Professional Modifier None Typical Low $15.85 Median $19.05 Typical High $19.05 | Professional | None | $15.85 | $19.05 | $19.05 |
Anthem BCBS Setting Professional Modifier None Typical Low $57.54 Median $83.18 Typical High $112.20 | Professional | None | $57.54 | $83.18 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $54.95 Typical High $54.95 | Facility | None | $48.98 | $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 $28.18 Median $35.48 Typical High $45.71 | Professional | None | $28.18 | $35.48 | $45.71 |
Medcost Setting Facility Modifier None Typical Low $16.60 Median $21.88 Typical High $26.92 | Facility | None | $16.60 | $21.88 | $26.92 |
Medcost Setting Professional Modifier None Typical Low $21.88 Median $26.92 Typical High $34.67 | Professional | None | $21.88 | $26.92 | $34.67 |
Sentara Setting Facility Modifier None Typical Low $20.89 Median $32.36 Typical High $85.11 | Facility | None | $20.89 | $32.36 | $85.11 |
Sentara Setting Professional Modifier None Typical Low $21.38 Median $33.11 Typical High $58.88 | Professional | None | $21.38 | $33.11 | $58.88 |
United Setting Professional Modifier None Typical Low $18.20 Median $22.39 Typical High $44.67 | Professional | None | $18.20 | $22.39 | $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 $7.94 Median $9.55 Typical High $9.55 | Professional | 52 · Reduced service | $7.94 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.16 Median $3.80 Typical High $3.80 | Professional | 53 · Discontinued | $3.16 | $3.80 | $3.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.40 Median $2.88 Typical High $2.88 | Professional | 55 · Aftercare only | $2.40 | $2.88 | $2.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.58 Median $1.91 Typical High $1.91 | Professional | 56 · Pre-op care only | $1.58 | $1.91 | $1.91 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.76 Median $6.76 Typical High $7.24 | Professional | RR · Rental | $6.76 | $6.76 | $7.24 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | UE · Used equipment | $51.29 | $51.29 | $51.29 |
Where Virginia sits
The same service costs 8.9 times more in North Dakota 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· 36th of 51
$31.62
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.