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 $43.65 Median $52.48 Typical High $52.48 | Facility | None | $43.65 | $52.48 | $52.48 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $52.48 Typical High $52.48 | Professional | None | $43.65 | $52.48 | $52.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.11 Median $47.86 Typical High $64.57 | Professional | None | $33.11 | $47.86 | $64.57 |
CareFirst Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $79.43 | Facility | None | $38.02 | $38.02 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $38.02 | Professional | None | $27.54 | $27.54 | $38.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $77.62 Median $95.50 Typical High $125.89 | Professional | None | $77.62 | $95.50 | $125.89 |
Medcost Setting Facility Modifier None Typical Low $44.67 Median $60.26 Typical High $72.44 | Facility | None | $44.67 | $60.26 | $72.44 |
Medcost Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $72.44 | Professional | None | $60.26 | $60.26 | $72.44 |
Sentara Setting Facility Modifier None Typical Low $56.23 Median $87.10 Typical High $229.09 | Facility | None | $56.23 | $87.10 | $229.09 |
Sentara Setting Professional Modifier None Typical Low $57.54 Median $87.10 Typical High $162.18 | Professional | None | $57.54 | $87.10 | $162.18 |
United Setting Professional Modifier None Typical Low $50.12 Median $60.26 Typical High $120.23 | Professional | None | $50.12 | $60.26 | $120.23 |
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 $21.38 Median $26.30 Typical High $26.30 | Professional | 52 · Reduced service | $21.38 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $10.47 Typical High $10.47 | Professional | 53 · Discontinued | $8.71 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $7.76 Typical High $7.76 | Professional | 55 · Aftercare only | $6.46 | $7.76 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $5.25 Typical High $5.25 | Professional | 56 · Pre-op care only | $4.37 | $5.25 | $5.25 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.89 Median $3.89 Typical High $4.17 | Professional | RR · Rental | $3.89 | $3.89 | $4.17 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | UE · Used equipment | $29.51 | $29.51 | $29.51 |
Where Virginia sits
The same service costs 49.0 times more in North Dakota than in Hawaii. 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· 17th of 51
$60.26
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.