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 $46.77 Median $56.23 Typical High $56.23 | Facility | None | $46.77 | $56.23 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $56.23 Typical High $57.54 | Professional | None | $46.77 | $56.23 | $57.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $123.03 | Facility | None | $114.82 | $114.82 | $123.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $72.44 | Professional | None | $66.07 | $66.07 | $72.44 |
CareFirst Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $79.43 | Professional | None | $75.86 | $75.86 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $70.79 Typical High $70.79 | Facility | None | $50.12 | $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 $81.28 Median $114.82 Typical High $151.36 | Professional | None | $81.28 | $114.82 | $151.36 |
Medcost Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
Medcost Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $83.18 | Facility | None | $61.66 | $61.66 | $83.18 |
Medcost Setting Professional Modifier None Typical Low $38.90 Median $52.48 Typical High $144.54 | Professional | None | $38.90 | $52.48 | $144.54 |
Sentara Setting Facility Modifier None Typical Low $63.10 Median $89.13 Typical High $177.83 | Facility | None | $63.10 | $89.13 | $177.83 |
Sentara Setting Professional Modifier None Typical Low $61.66 Median $89.13 Typical High $154.88 | Professional | None | $61.66 | $89.13 | $154.88 |
United Setting Facility Modifier None Typical Low $57.54 Median $63.10 Typical High $141.25 | Facility | None | $57.54 | $63.10 | $141.25 |
United Setting Professional Modifier None Typical Low $52.48 Median $56.23 Typical High $89.13 | Professional | None | $52.48 | $56.23 | $89.13 |
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 $22.91 Median $28.18 Typical High $28.18 | Professional | 52 · Reduced service | $22.91 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $11.22 Typical High $11.22 | Professional | 53 · Discontinued | $9.33 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $8.32 Typical High $8.32 | Professional | 55 · Aftercare only | $6.92 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $5.62 Typical High $5.62 | Professional | 56 · Pre-op care only | $4.68 | $5.62 | $5.62 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.92 Median $6.92 Typical High $8.13 | Professional | RR · Rental | $6.92 | $6.92 | $8.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $50.12 Median $51.29 Typical High $53.70 | Professional | UE · Used equipment | $50.12 | $51.29 | $53.70 |
Where Virginia sits
The same service costs 2.4 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· 29th 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.