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 $35.48 Median $42.66 Typical High $42.66 | Facility | None | $35.48 | $42.66 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $35.48 Median $42.66 Typical High $89.13 | Professional | None | $35.48 | $42.66 | $89.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $93.33 | Facility | None | $89.13 | $89.13 | $93.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $53.70 | Professional | None | $46.77 | $46.77 | $53.70 |
CareFirst Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $60.26 | Professional | None | $45.71 | $45.71 | $60.26 |
Cigna Setting Facility Modifier None Typical Low $39.81 Median $50.12 Typical High $50.12 | Facility | None | $39.81 | $50.12 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $50.12 | Professional | None | $36.31 | $36.31 | $50.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $61.66 Median $89.13 Typical High $114.82 | Professional | None | $61.66 | $89.13 | $114.82 |
Medcost Setting Professional Modifier None Typical Low $44.67 Median $57.54 Typical High $81.28 | Professional | None | $44.67 | $57.54 | $81.28 |
Medcost Setting Facility Modifier None Typical Low $28.18 Median $47.86 Typical High $57.54 | Facility | None | $28.18 | $47.86 | $57.54 |
Medcost Setting Professional Modifier None Typical Low $19.95 Median $52.48 Typical High $109.65 | Professional | None | $19.95 | $52.48 | $109.65 |
Sentara Setting Facility Modifier None Typical Low $36.31 Median $61.66 Typical High $190.55 | Facility | None | $36.31 | $61.66 | $190.55 |
Sentara Setting Professional Modifier None Typical Low $14.79 Median $64.57 Typical High $131.83 | Professional | None | $14.79 | $64.57 | $131.83 |
United Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $128.82 | Facility | None | $107.15 | $107.15 | $128.82 |
United Setting Professional Modifier None Typical Low $38.90 Median $43.65 Typical High $64.57 | Professional | None | $38.90 | $43.65 | $64.57 |
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 $17.78 Median $21.38 Typical High $21.38 | Professional | 52 · Reduced service | $17.78 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $8.51 Typical High $8.51 | Professional | 53 · Discontinued | $7.08 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $6.46 Typical High $6.46 | Professional | 55 · Aftercare only | $5.37 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $4.27 Typical High $4.27 | Professional | 56 · Pre-op care only | $3.55 | $4.27 | $4.27 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.79 Median $4.79 Typical High $6.31 | Professional | RR · Rental | $4.79 | $4.79 | $6.31 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $34.67 Median $36.31 Typical High $36.31 | Professional | UE · Used equipment | $34.67 | $36.31 | $36.31 |
Where Virginia sits
The same service costs 3.0 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· 35th of 51
$46.77
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.