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 $20.42 Median $24.55 Typical High $24.55 | Facility | None | $20.42 | $24.55 | $24.55 |
Aetna Setting Professional Modifier None Typical Low $20.42 Median $24.55 Typical High $24.55 | Professional | None | $20.42 | $24.55 | $24.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $53.70 | Facility | None | $50.12 | $50.12 | $53.70 |
Anthem BCBS Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $33.88 | Professional | None | $27.54 | $27.54 | $33.88 |
CareFirst Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $34.67 | Professional | None | $31.62 | $31.62 | $34.67 |
Cigna Setting Facility Modifier None Typical Low $22.39 Median $33.88 Typical High $33.88 | Facility | None | $22.39 | $33.88 | $33.88 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $33.88 | Professional | None | $24.55 | $24.55 | $33.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $35.48 Median $50.12 Typical High $66.07 | Professional | None | $35.48 | $50.12 | $66.07 |
Medcost Setting Professional Modifier None Typical Low $25.70 Median $33.11 Typical High $45.71 | Professional | None | $25.70 | $33.11 | $45.71 |
Medcost Setting Facility Modifier None Typical Low $15.85 Median $26.92 Typical High $33.11 | Facility | None | $15.85 | $26.92 | $33.11 |
Medcost Setting Professional Modifier None Typical Low $26.92 Median $30.20 Typical High $63.10 | Professional | None | $26.92 | $30.20 | $63.10 |
Sentara Setting Facility Modifier None Typical Low $20.42 Median $35.48 Typical High $107.15 | Facility | None | $20.42 | $35.48 | $107.15 |
Sentara Setting Professional Modifier None Typical Low $10.72 Median $37.15 Typical High $75.86 | Professional | None | $10.72 | $37.15 | $75.86 |
United Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $74.13 | Facility | None | $61.66 | $61.66 | $74.13 |
United Setting Professional Modifier None Typical Low $22.39 Median $24.55 Typical High $37.15 | Professional | None | $22.39 | $24.55 | $37.15 |
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 $10.00 Median $12.30 Typical High $12.30 | Professional | 52 · Reduced service | $10.00 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $4.90 Typical High $4.90 | Professional | 53 · Discontinued | $4.07 | $4.90 | $4.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $3.63 Typical High $3.63 | Professional | 55 · Aftercare only | $3.02 | $3.63 | $3.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.45 Typical High $2.45 | Professional | 56 · Pre-op care only | $2.04 | $2.45 | $2.45 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.75 Median $2.75 Typical High $3.55 | Professional | RR · Rental | $2.75 | $2.75 | $3.55 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $20.42 Median $20.42 Typical High $22.39 | Professional | UE · Used equipment | $20.42 | $20.42 | $22.39 |
Where Virginia sits
The same service costs 2.2 times more in Montana than in Arizona. 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· 32nd of 51
$27.54
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.