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 $23.99 Median $28.84 Typical High $28.84 | Facility | None | $23.99 | $28.84 | $28.84 |
Aetna Setting Professional Modifier None Typical Low $23.99 Median $28.84 Typical High $28.84 | Professional | None | $23.99 | $28.84 | $28.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $63.10 | Facility | None | $58.88 | $58.88 | $63.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $38.90 | Professional | None | $31.62 | $31.62 | $38.90 |
CareFirst Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
Cigna Setting Facility Modifier None Typical Low $26.92 Median $33.11 Typical High $33.11 | Facility | None | $26.92 | $33.11 | $33.11 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $33.11 | Professional | None | $24.55 | $24.55 | $33.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $41.69 Median $58.88 Typical High $77.62 | Professional | None | $41.69 | $58.88 | $77.62 |
Medcost Setting Professional Modifier None Typical Low $30.20 Median $38.90 Typical High $54.95 | Professional | None | $30.20 | $38.90 | $54.95 |
Medcost Setting Facility Modifier None Typical Low $19.05 Median $31.62 Typical High $38.90 | Facility | None | $19.05 | $31.62 | $38.90 |
Medcost Setting Professional Modifier None Typical Low $31.62 Median $36.31 Typical High $74.13 | Professional | None | $31.62 | $36.31 | $74.13 |
Sentara Setting Facility Modifier None Typical Low $26.92 Median $41.69 Typical High $128.82 | Facility | None | $26.92 | $41.69 | $128.82 |
Sentara Setting Professional Modifier None Typical Low $30.20 Median $43.65 Typical High $89.13 | Professional | None | $30.20 | $43.65 | $89.13 |
United Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $87.10 | Facility | None | $72.44 | $72.44 | $87.10 |
United Setting Professional Modifier None Typical Low $26.30 Median $28.84 Typical High $43.65 | Professional | None | $26.30 | $28.84 | $43.65 |
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 $12.02 Median $14.45 Typical High $14.45 | Professional | 52 · Reduced service | $12.02 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $5.75 Typical High $5.75 | Professional | 53 · Discontinued | $4.79 | $5.75 | $5.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.55 Median $4.37 Typical High $4.37 | Professional | 55 · Aftercare only | $3.55 | $4.37 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.40 Median $2.88 Typical High $2.88 | Professional | 56 · Pre-op care only | $2.40 | $2.88 | $2.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.16 Median $3.16 Typical High $4.27 | Professional | RR · Rental | $3.16 | $3.16 | $4.27 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $23.99 Median $23.99 Typical High $25.70 | Professional | UE · Used equipment | $23.99 | $23.99 | $25.70 |
Where Virginia sits
The same service costs 2.8 times more in Kansas 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
$31.62
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.