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 $39.81 Median $48.98 Typical High $48.98 | Facility | None | $39.81 | $48.98 | $48.98 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $48.98 Typical High $48.98 | Professional | None | $39.81 | $48.98 | $48.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $107.15 | Facility | None | $100.00 | $100.00 | $107.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $60.26 | Professional | None | $50.12 | $50.12 | $60.26 |
CareFirst Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $69.18 | Professional | None | $64.57 | $64.57 | $69.18 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $53.70 Typical High $53.70 | Facility | None | $43.65 | $53.70 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $53.70 | Professional | None | $38.90 | $38.90 | $53.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $70.79 Median $100.00 Typical High $128.82 | Professional | None | $70.79 | $100.00 | $128.82 |
Medcost Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
Medcost Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $69.18 | Facility | None | $53.70 | $53.70 | $69.18 |
Medcost Setting Professional Modifier None Typical Low $31.62 Median $42.66 Typical High $125.89 | Professional | None | $31.62 | $42.66 | $125.89 |
Sentara Setting Facility Modifier None Typical Low $54.95 Median $77.62 Typical High $151.36 | Facility | None | $54.95 | $77.62 | $151.36 |
Sentara Setting Professional Modifier None Typical Low $53.70 Median $77.62 Typical High $134.90 | Professional | None | $53.70 | $77.62 | $134.90 |
United Setting Facility Modifier None Typical Low $16.98 Median $39.81 Typical High $117.49 | Facility | None | $16.98 | $39.81 | $117.49 |
United Setting Professional Modifier None Typical Low $43.65 Median $48.98 Typical High $77.62 | Professional | None | $43.65 | $48.98 | $77.62 |
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 $19.95 Median $24.55 Typical High $24.55 | Professional | 52 · Reduced service | $19.95 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $9.77 Typical High $9.77 | Professional | 53 · Discontinued | $7.94 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $7.24 Typical High $7.24 | Professional | 55 · Aftercare only | $6.03 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $4.79 Typical High $4.79 | Professional | 56 · Pre-op care only | $3.98 | $4.79 | $4.79 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.01 Median $5.01 Typical High $6.92 | Professional | RR · Rental | $5.01 | $5.01 | $6.92 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $38.02 Median $38.02 Typical High $40.74 | Professional | UE · Used equipment | $38.02 | $38.02 | $40.74 |
Where Virginia sits
The same service costs 3.3 times more in Hawaii 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· 38th of 51
$50.12
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.