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 $18.20 Median $22.39 Typical High $22.39 | Facility | None | $18.20 | $22.39 | $22.39 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $22.39 Typical High $22.39 | Professional | None | $18.20 | $22.39 | $22.39 |
Anthem BCBS Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $48.98 | Facility | None | $45.71 | $45.71 | $48.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $27.54 | Professional | None | $23.99 | $23.99 | $27.54 |
CareFirst Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $31.62 | Professional | None | $23.44 | $23.44 | $31.62 |
Cigna Setting Facility Modifier None Typical Low $20.42 Median $26.92 Typical High $26.92 | Facility | None | $20.42 | $26.92 | $26.92 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $26.92 | Professional | None | $19.95 | $19.95 | $26.92 |
Kaiser Permanente Setting Professional Modifier None Typical Low $32.36 Median $45.71 Typical High $58.88 | Professional | None | $32.36 | $45.71 | $58.88 |
Medcost Setting Professional Modifier None Typical Low $22.91 Median $30.20 Typical High $41.69 | Professional | None | $22.91 | $30.20 | $41.69 |
Medcost Setting Facility Modifier None Typical Low $14.45 Median $24.55 Typical High $30.20 | Facility | None | $14.45 | $24.55 | $30.20 |
Medcost Setting Professional Modifier None Typical Low $24.55 Median $27.54 Typical High $57.54 | Professional | None | $24.55 | $27.54 | $57.54 |
Sentara Setting Facility Modifier None Typical Low $18.62 Median $32.36 Typical High $97.72 | Facility | None | $18.62 | $32.36 | $97.72 |
Sentara Setting Professional Modifier None Typical Low $14.79 Median $33.88 Typical High $69.18 | Professional | None | $14.79 | $33.88 | $69.18 |
United Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $67.61 | Facility | None | $56.23 | $56.23 | $67.61 |
United Setting Professional Modifier None Typical Low $20.42 Median $22.39 Typical High $33.88 | Professional | None | $20.42 | $22.39 | $33.88 |
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 $9.12 Median $11.22 Typical High $11.22 | Professional | 52 · Reduced service | $9.12 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $4.47 Typical High $4.47 | Professional | 53 · Discontinued | $3.63 | $4.47 | $4.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $3.31 Typical High $3.31 | Professional | 55 · Aftercare only | $2.75 | $3.31 | $3.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $2.24 Typical High $2.24 | Professional | 56 · Pre-op care only | $1.82 | $2.24 | $2.24 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.51 Median $2.51 Typical High $3.24 | Professional | RR · Rental | $2.51 | $2.51 | $3.24 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $18.20 Median $18.62 Typical High $19.50 | Professional | UE · Used equipment | $18.20 | $18.62 | $19.50 |
Where Virginia sits
The same service costs 2.5 times more in Montana than in Delaware. 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· 39th of 51
$23.99
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.