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 $14.13 Median $16.98 Typical High $16.98 | Facility | None | $14.13 | $16.98 | $16.98 |
Aetna Setting Professional Modifier None Typical Low $14.13 Median $16.98 Typical High $16.98 | Professional | None | $14.13 | $16.98 | $16.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $37.15 | Facility | None | $35.48 | $35.48 | $37.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $22.91 | Professional | None | $18.62 | $18.62 | $22.91 |
CareFirst Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $23.99 | Professional | None | $20.89 | $20.89 | $23.99 |
Cigna Setting Facility Modifier None Typical Low $15.85 Median $24.55 Typical High $24.55 | Facility | None | $15.85 | $24.55 | $24.55 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $24.55 | Professional | None | $17.78 | $17.78 | $24.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $24.55 Median $35.48 Typical High $45.71 | Professional | None | $24.55 | $35.48 | $45.71 |
Medcost Setting Professional Modifier None Typical Low $17.78 Median $22.91 Typical High $32.36 | Professional | None | $17.78 | $22.91 | $32.36 |
Medcost Setting Facility Modifier None Typical Low $11.22 Median $19.05 Typical High $22.91 | Facility | None | $11.22 | $19.05 | $22.91 |
Medcost Setting Professional Modifier None Typical Low $19.05 Median $21.38 Typical High $43.65 | Professional | None | $19.05 | $21.38 | $43.65 |
Sentara Setting Facility Modifier None Typical Low $16.60 Median $24.55 Typical High $75.86 | Facility | None | $16.60 | $24.55 | $75.86 |
Sentara Setting Professional Modifier None Typical Low $17.78 Median $25.70 Typical High $53.70 | Professional | None | $17.78 | $25.70 | $53.70 |
United Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $51.29 | Facility | None | $42.66 | $42.66 | $51.29 |
United Setting Professional Modifier None Typical Low $15.49 Median $16.98 Typical High $25.70 | Professional | None | $15.49 | $16.98 | $25.70 |
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 $7.08 Median $8.51 Typical High $8.51 | Professional | 52 · Reduced service | $7.08 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $3.39 Typical High $3.39 | Professional | 53 · Discontinued | $2.82 | $3.39 | $3.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.09 Median $2.51 Typical High $2.51 | Professional | 55 · Aftercare only | $2.09 | $2.51 | $2.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.41 Median $1.70 Typical High $1.70 | Professional | 56 · Pre-op care only | $1.41 | $1.70 | $1.70 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.82 Median $1.82 Typical High $2.51 | Professional | RR · Rental | $1.82 | $1.82 | $2.51 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | UE · Used equipment | $13.80 | $13.80 | $13.80 |
Where Virginia sits
The same service costs 2.1 times more in Montana than in West Virginia. 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
$18.62
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.