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 $30.90 Median $38.02 Typical High $38.02 | Facility | None | $30.90 | $38.02 | $38.02 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $38.02 Typical High $38.02 | Professional | None | $30.90 | $38.02 | $38.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $83.18 | Facility | None | $77.62 | $77.62 | $83.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $52.48 | Professional | None | $42.66 | $42.66 | $52.48 |
CareFirst Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $53.70 | Professional | None | $39.81 | $39.81 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $43.65 Typical High $43.65 | Facility | None | $34.67 | $43.65 | $43.65 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $43.65 | Professional | None | $31.62 | $31.62 | $43.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $54.95 Median $77.62 Typical High $100.00 | Professional | None | $54.95 | $77.62 | $100.00 |
Medcost Setting Professional Modifier None Typical Low $39.81 Median $51.29 Typical High $70.79 | Professional | None | $39.81 | $51.29 | $70.79 |
Medcost Setting Facility Modifier None Typical Low $24.55 Median $41.69 Typical High $51.29 | Facility | None | $24.55 | $41.69 | $51.29 |
Medcost Setting Professional Modifier None Typical Low $41.69 Median $46.77 Typical High $97.72 | Professional | None | $41.69 | $46.77 | $97.72 |
Sentara Setting Facility Modifier None Typical Low $37.15 Median $54.95 Typical High $165.96 | Facility | None | $37.15 | $54.95 | $165.96 |
Sentara Setting Professional Modifier None Typical Low $39.81 Median $57.54 Typical High $117.49 | Professional | None | $39.81 | $57.54 | $117.49 |
United Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $114.82 | Facility | None | $95.50 | $95.50 | $114.82 |
United Setting Professional Modifier None Typical Low $34.67 Median $38.02 Typical High $57.54 | Professional | None | $34.67 | $38.02 | $57.54 |
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 $15.49 Median $19.05 Typical High $19.05 | Professional | 52 · Reduced service | $15.49 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $7.59 Typical High $7.59 | Professional | 53 · Discontinued | $6.31 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $5.62 Typical High $5.62 | Professional | 55 · Aftercare only | $4.68 | $5.62 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.80 Typical High $3.80 | Professional | 56 · Pre-op care only | $3.09 | $3.80 | $3.80 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.27 Median $4.27 Typical High $5.50 | Professional | RR · Rental | $4.27 | $4.27 | $5.50 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | UE · Used equipment | $31.62 | $31.62 | $31.62 |
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· 35th of 51
$42.66
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.