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 $11.48 Median $13.80 Typical High $13.80 | Facility | None | $11.48 | $13.80 | $13.80 |
Aetna Setting Professional Modifier None Typical Low $11.48 Median $13.80 Typical High $13.80 | Professional | None | $11.48 | $13.80 | $13.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $46.77 Median $67.61 Typical High $91.20 | Professional | None | $46.77 | $67.61 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $18.62 Median $28.18 Typical High $28.18 | Facility | None | $18.62 | $28.18 | $28.18 |
Cigna Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $28.18 | Professional | None | $20.42 | $20.42 | $28.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $20.42 Median $25.70 Typical High $33.11 | Professional | None | $20.42 | $25.70 | $33.11 |
Medcost Setting Facility Modifier None Typical Low $12.02 Median $15.85 Typical High $19.50 | Facility | None | $12.02 | $15.85 | $19.50 |
Medcost Setting Professional Modifier None Typical Low $12.02 Median $15.85 Typical High $19.50 | Professional | None | $12.02 | $15.85 | $19.50 |
Sentara Setting Facility Modifier None Typical Low $14.79 Median $23.44 Typical High $61.66 | Facility | None | $14.79 | $23.44 | $61.66 |
Sentara Setting Professional Modifier None Typical Low $15.49 Median $23.99 Typical High $42.66 | Professional | None | $15.49 | $23.99 | $42.66 |
United Setting Professional Modifier None Typical Low $13.18 Median $16.22 Typical High $32.36 | Professional | None | $13.18 | $16.22 | $32.36 |
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 $5.75 Median $6.92 Typical High $6.92 | Professional | 52 · Reduced service | $5.75 | $6.92 | $6.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $2.75 Typical High $2.75 | Professional | 53 · Discontinued | $2.29 | $2.75 | $2.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.74 Median $2.09 Typical High $2.09 | Professional | 55 · Aftercare only | $1.74 | $2.09 | $2.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.15 Median $1.38 Typical High $1.38 | Professional | 56 · Pre-op care only | $1.15 | $1.38 | $1.38 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.50 Median $5.50 Typical High $5.89 | Professional | RR · Rental | $5.50 | $5.50 | $5.89 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | UE · Used equipment | $40.74 | $40.74 | $40.74 |
Where Virginia sits
The same service costs 8.7 times more in Hawaii than in Kansas. 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
$20.42
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.