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 $42.66 Median $51.29 Typical High $51.29 | Facility | None | $42.66 | $51.29 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $51.29 Typical High $70.79 | Professional | None | $42.66 | $51.29 | $70.79 |
Anthem BCBS Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $112.20 | Facility | None | $104.71 | $104.71 | $112.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $64.57 | Professional | None | $56.23 | $56.23 | $64.57 |
CareFirst Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $72.44 | Professional | None | $69.18 | $69.18 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $42.66 Median $61.66 Typical High $61.66 | Facility | None | $42.66 | $61.66 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $61.66 | Professional | None | $44.67 | $44.67 | $61.66 |
Kaiser Permanente Setting Professional Modifier None Typical Low $74.13 Median $104.71 Typical High $138.04 | Professional | None | $74.13 | $104.71 | $138.04 |
Medcost Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Medcost Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $77.62 | Facility | None | $56.23 | $56.23 | $77.62 |
Medcost Setting Professional Modifier None Typical Low $52.48 Median $70.79 Typical High $131.83 | Professional | None | $52.48 | $70.79 | $131.83 |
Sentara Setting Facility Modifier None Typical Low $57.54 Median $81.28 Typical High $162.18 | Facility | None | $57.54 | $81.28 | $162.18 |
Sentara Setting Professional Modifier None Typical Low $56.23 Median $81.28 Typical High $141.25 | Professional | None | $56.23 | $81.28 | $141.25 |
United Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $131.83 | Facility | None | $72.44 | $72.44 | $131.83 |
United Setting Professional Modifier None Typical Low $47.86 Median $51.29 Typical High $81.28 | Professional | None | $47.86 | $51.29 | $81.28 |
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 $21.38 Median $25.70 Typical High $25.70 | Professional | 52 · Reduced service | $21.38 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $10.23 Typical High $10.23 | Professional | 53 · Discontinued | $8.51 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $7.59 Typical High $7.59 | Professional | 55 · Aftercare only | $6.31 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $5.13 Typical High $5.13 | Professional | 56 · Pre-op care only | $4.27 | $5.13 | $5.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.75 Median $5.75 Typical High $7.24 | Professional | RR · Rental | $5.75 | $5.75 | $7.24 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $42.66 Median $43.65 Typical High $43.65 | Professional | UE · Used equipment | $42.66 | $43.65 | $43.65 |
Where Virginia sits
The same service costs 2.1 times more in Wisconsin than in New Jersey. 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
$56.23
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.