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 $26.30 Median $31.62 Typical High $31.62 | Facility | None | $26.30 | $31.62 | $31.62 |
Aetna Setting Professional Modifier None Typical Low $26.30 Median $31.62 Typical High $31.62 | Professional | None | $26.30 | $31.62 | $31.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $69.18 | Facility | None | $66.07 | $66.07 | $69.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $38.90 | Professional | None | $34.67 | $34.67 | $38.90 |
CareFirst Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $44.67 | Professional | None | $33.88 | $33.88 | $44.67 |
Cigna Setting Facility Modifier None Typical Low $29.51 Median $37.15 Typical High $37.15 | Facility | None | $29.51 | $37.15 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $37.15 | Professional | None | $26.92 | $26.92 | $37.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $45.71 Median $66.07 Typical High $85.11 | Professional | None | $45.71 | $66.07 | $85.11 |
Medcost Setting Professional Modifier None Typical Low $33.11 Median $42.66 Typical High $60.26 | Professional | None | $33.11 | $42.66 | $60.26 |
Medcost Setting Facility Modifier None Typical Low $20.89 Median $35.48 Typical High $42.66 | Facility | None | $20.89 | $35.48 | $42.66 |
Medcost Setting Professional Modifier None Typical Low $35.48 Median $39.81 Typical High $81.28 | Professional | None | $35.48 | $39.81 | $81.28 |
Sentara Setting Facility Modifier None Typical Low $26.92 Median $45.71 Typical High $141.25 | Facility | None | $26.92 | $45.71 | $141.25 |
Sentara Setting Professional Modifier None Typical Low $24.55 Median $47.86 Typical High $100.00 | Professional | None | $24.55 | $47.86 | $100.00 |
United Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $95.50 | Facility | None | $79.43 | $79.43 | $95.50 |
United Setting Professional Modifier None Typical Low $28.84 Median $32.36 Typical High $47.86 | Professional | None | $28.84 | $32.36 | $47.86 |
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 $13.18 Median $15.85 Typical High $15.85 | Professional | 52 · Reduced service | $13.18 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $6.31 Typical High $6.31 | Professional | 53 · Discontinued | $5.25 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $4.79 Typical High $4.79 | Professional | 55 · Aftercare only | $3.98 | $4.79 | $4.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $3.16 Typical High $3.16 | Professional | 56 · Pre-op care only | $2.63 | $3.16 | $3.16 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.55 Median $3.55 Typical High $4.68 | Professional | RR · Rental | $3.55 | $3.55 | $4.68 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $25.70 Median $26.92 Typical High $26.92 | Professional | UE · Used equipment | $25.70 | $26.92 | $26.92 |
Where Virginia sits
The same service costs 2.6 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
$34.67
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.