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 $36.31 Median $44.67 Typical High $44.67 | Facility | None | $36.31 | $44.67 | $44.67 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $44.67 Typical High $44.67 | Professional | None | $36.31 | $44.67 | $44.67 |
Anthem BCBS Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $97.72 | Facility | None | $91.20 | $91.20 | $97.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $58.88 | Professional | None | $47.86 | $47.86 | $58.88 |
CareFirst Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $63.10 | Professional | None | $48.98 | $48.98 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $57.54 Typical High $57.54 | Facility | None | $40.74 | $57.54 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $57.54 | Professional | None | $41.69 | $41.69 | $57.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $64.57 Median $91.20 Typical High $120.23 | Professional | None | $64.57 | $91.20 | $120.23 |
Medcost Setting Professional Modifier None Typical Low $46.77 Median $60.26 Typical High $83.18 | Professional | None | $46.77 | $60.26 | $83.18 |
Medcost Setting Facility Modifier None Typical Low $28.84 Median $48.98 Typical High $60.26 | Facility | None | $28.84 | $48.98 | $60.26 |
Medcost Setting Professional Modifier None Typical Low $48.98 Median $54.95 Typical High $114.82 | Professional | None | $48.98 | $54.95 | $114.82 |
Sentara Setting Facility Modifier None Typical Low $37.15 Median $64.57 Typical High $194.98 | Facility | None | $37.15 | $64.57 | $194.98 |
Sentara Setting Professional Modifier None Typical Low $39.81 Median $67.61 Typical High $138.04 | Professional | None | $39.81 | $67.61 | $138.04 |
United Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $134.90 | Facility | None | $112.20 | $112.20 | $134.90 |
United Setting Professional Modifier None Typical Low $40.74 Median $44.67 Typical High $67.61 | Professional | None | $40.74 | $44.67 | $67.61 |
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 $18.20 Median $22.39 Typical High $22.39 | Professional | 52 · Reduced service | $18.20 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $8.91 Typical High $8.91 | Professional | 53 · Discontinued | $7.41 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $6.61 Typical High $6.61 | Professional | 55 · Aftercare only | $5.50 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $4.47 Typical High $4.47 | Professional | 56 · Pre-op care only | $3.63 | $4.47 | $4.47 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.79 Median $4.79 Typical High $6.46 | Professional | RR · Rental | $4.79 | $4.79 | $6.46 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | UE · Used equipment | $36.31 | $36.31 | $36.31 |
Where Virginia sits
The same service costs 2.3 times more in Montana than in Florida. 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· 36th of 51
$47.86
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.