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 $16.60 Median $19.95 Typical High $19.95 | Facility | None | $16.60 | $19.95 | $19.95 |
Aetna Setting Professional Modifier None Typical Low $16.60 Median $19.95 Typical High $19.95 | Professional | None | $16.60 | $19.95 | $19.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $43.65 | Facility | None | $40.74 | $40.74 | $43.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $16.60 | Professional | None | $13.18 | $13.18 | $16.60 |
CareFirst Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $28.18 | Professional | None | $21.38 | $21.38 | $28.18 |
Cigna Setting Facility Modifier None Typical Low $18.62 Median $22.91 Typical High $22.91 | Facility | None | $18.62 | $22.91 | $22.91 |
Cigna Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $22.91 | Professional | None | $16.98 | $16.98 | $22.91 |
Kaiser Permanente Setting Professional Modifier None Typical Low $28.84 Median $40.74 Typical High $53.70 | Professional | None | $28.84 | $40.74 | $53.70 |
Medcost Setting Professional Modifier None Typical Low $20.89 Median $26.92 Typical High $38.02 | Professional | None | $20.89 | $26.92 | $38.02 |
Medcost Setting Facility Modifier None Typical Low $13.18 Median $21.88 Typical High $26.92 | Facility | None | $13.18 | $21.88 | $26.92 |
Medcost Setting Professional Modifier None Typical Low $21.88 Median $25.12 Typical High $51.29 | Professional | None | $21.88 | $25.12 | $51.29 |
Sentara Setting Facility Modifier None Typical Low $19.50 Median $28.84 Typical High $89.13 | Facility | None | $19.50 | $28.84 | $89.13 |
Sentara Setting Professional Modifier None Typical Low $20.89 Median $30.20 Typical High $61.66 | Professional | None | $20.89 | $30.20 | $61.66 |
United Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $60.26 | Facility | None | $50.12 | $50.12 | $60.26 |
United Setting Professional Modifier None Typical Low $18.20 Median $19.95 Typical High $30.20 | Professional | None | $18.20 | $19.95 | $30.20 |
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 $8.32 Median $10.00 Typical High $10.00 | Professional | 52 · Reduced service | $8.32 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.31 Median $3.98 Typical High $3.98 | Professional | 53 · Discontinued | $3.31 | $3.98 | $3.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.45 Median $3.02 Typical High $3.02 | Professional | 55 · Aftercare only | $2.45 | $3.02 | $3.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.66 Median $2.00 Typical High $2.00 | Professional | 56 · Pre-op care only | $1.66 | $2.00 | $2.00 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.95 Median $9.12 Typical High $13.18 | Professional | RR · Rental | $2.95 | $9.12 | $13.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | UE · Used equipment | $10.00 | $10.00 | $10.00 |
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· 44th of 51
$19.95
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.