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 $6.61 Median $7.94 Typical High $12.30 | Facility | None | $6.61 | $7.94 | $12.30 |
Aetna Setting Professional Modifier None Typical Low $6.61 Median $7.94 Typical High $10.47 | Professional | None | $6.61 | $7.94 | $10.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $19.05 | Professional | None | $14.45 | $14.45 | $19.05 |
CareFirst Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | None | $22.91 | $22.91 | $22.91 |
Cigna Setting Facility Modifier None Typical Low $13.49 Median $20.89 Typical High $21.38 | Facility | None | $13.49 | $20.89 | $21.38 |
Cigna Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $20.89 | Professional | None | $15.49 | $15.49 | $20.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $11.75 Median $14.45 Typical High $19.05 | Professional | None | $11.75 | $14.45 | $19.05 |
Medcost Setting Facility Modifier None Typical Low $6.76 Median $9.12 Typical High $10.96 | Facility | None | $6.76 | $9.12 | $10.96 |
Medcost Setting Professional Modifier None Typical Low $9.12 Median $30.90 Typical High $61.66 | Professional | None | $9.12 | $30.90 | $61.66 |
Sentara Setting Facility Modifier None Typical Low $6.61 Median $13.18 Typical High $66.07 | Facility | None | $6.61 | $13.18 | $66.07 |
Sentara Setting Professional Modifier None Typical Low $8.51 Median $13.49 Typical High $31.62 | Professional | None | $8.51 | $13.49 | $31.62 |
United Setting Professional Modifier None Typical Low $7.59 Median $9.12 Typical High $18.20 | Professional | None | $7.59 | $9.12 | $18.20 |
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 $3.31 Median $3.98 Typical High $3.98 | Professional | 52 · Reduced service | $3.31 | $3.98 | $3.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.32 Median $1.58 Typical High $1.58 | Professional | 53 · Discontinued | $1.32 | $1.58 | $1.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.98 Median $1.17 Typical High $1.17 | Professional | 55 · Aftercare only | $0.98 | $1.17 | $1.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.66 Median $0.79 Typical High $0.79 | Professional | 56 · Pre-op care only | $0.66 | $0.79 | $0.79 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.45 Median $1.45 Typical High $1.51 | Professional | RR · Rental | $1.45 | $1.45 | $1.51 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $10.72 Median $10.96 Typical High $10.96 | Professional | UE · Used equipment | $10.72 | $10.96 | $10.96 |
Where Virginia sits
The same service costs 6.2 times more in Wyoming than in North Carolina. 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· 19th of 51
$14.45
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.