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 $51.29 Median $61.66 Typical High $61.66 | Facility | None | $51.29 | $61.66 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $61.66 Typical High $61.66 | Professional | None | $51.29 | $61.66 | $61.66 |
Anthem BCBS Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $134.90 | Facility | None | $125.89 | $125.89 | $134.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $81.28 | Professional | None | $66.07 | $66.07 | $81.28 |
CareFirst Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $87.10 | Professional | None | $64.57 | $64.57 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $70.79 Typical High $70.79 | Facility | None | $56.23 | $70.79 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $70.79 | Professional | None | $51.29 | $51.29 | $70.79 |
Kaiser Permanente Setting Professional Modifier None Typical Low $89.13 Median $125.89 Typical High $165.96 | Professional | None | $89.13 | $125.89 | $165.96 |
Medcost Setting Professional Modifier None Typical Low $64.57 Median $83.18 Typical High $114.82 | Professional | None | $64.57 | $83.18 | $114.82 |
Medcost Setting Facility Modifier None Typical Low $39.81 Median $67.61 Typical High $83.18 | Facility | None | $39.81 | $67.61 | $83.18 |
Medcost Setting Professional Modifier None Typical Low $67.61 Median $75.86 Typical High $158.49 | Professional | None | $67.61 | $75.86 | $158.49 |
Sentara Setting Facility Modifier None Typical Low $51.29 Median $89.13 Typical High $269.15 | Facility | None | $51.29 | $89.13 | $269.15 |
Sentara Setting Professional Modifier None Typical Low $34.67 Median $93.33 Typical High $190.55 | Professional | None | $34.67 | $93.33 | $190.55 |
United Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $186.21 | Facility | None | $154.88 | $154.88 | $186.21 |
United Setting Professional Modifier None Typical Low $56.23 Median $61.66 Typical High $93.33 | Professional | None | $56.23 | $61.66 | $93.33 |
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 $25.70 Median $30.90 Typical High $30.90 | Professional | 52 · Reduced service | $25.70 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $12.30 Typical High $12.30 | Professional | 53 · Discontinued | $10.23 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $9.12 Typical High $9.12 | Professional | 55 · Aftercare only | $7.59 | $9.12 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $6.17 Typical High $6.17 | Professional | 56 · Pre-op care only | $5.13 | $6.17 | $6.17 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.61 Median $6.61 Typical High $8.91 | Professional | RR · Rental | $6.61 | $6.61 | $8.91 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $50.12 Median $50.12 Typical High $53.70 | Professional | UE · Used equipment | $50.12 | $50.12 | $53.70 |
Where Virginia sits
The same service costs 2.6 times more in Hawaii 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· 34th of 51
$66.07
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.