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 $53.70 Median $64.57 Typical High $64.57 | Facility | None | $53.70 | $64.57 | $64.57 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $64.57 Typical High $64.57 | Professional | None | $53.70 | $64.57 | $64.57 |
Anthem BCBS Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $141.25 | Facility | None | $131.83 | $131.83 | $141.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $85.11 | Professional | None | $69.18 | $69.18 | $85.11 |
CareFirst Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $91.20 | Professional | None | $70.79 | $70.79 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $85.11 Typical High $85.11 | Facility | None | $51.29 | $85.11 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $85.11 | Professional | None | $61.66 | $61.66 | $85.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $93.33 Median $131.83 Typical High $173.78 | Professional | None | $93.33 | $131.83 | $173.78 |
Medcost Setting Professional Modifier None Typical Low $77.62 Median $87.10 Typical High $123.03 | Professional | None | $77.62 | $87.10 | $123.03 |
Medcost Setting Facility Modifier None Typical Low $40.74 Median $70.79 Typical High $87.10 | Facility | None | $40.74 | $70.79 | $87.10 |
Medcost Setting Professional Modifier None Typical Low $52.48 Median $69.18 Typical High $165.96 | Professional | None | $52.48 | $69.18 | $165.96 |
Sentara Setting Facility Modifier None Typical Low $64.57 Median $93.33 Typical High $288.40 | Facility | None | $64.57 | $93.33 | $288.40 |
Sentara Setting Professional Modifier None Typical Low $70.79 Median $97.72 Typical High $199.53 | Professional | None | $70.79 | $97.72 | $199.53 |
United Setting Facility Modifier None Typical Low $48.98 Median $64.57 Typical High $154.88 | Facility | None | $48.98 | $64.57 | $154.88 |
United Setting Professional Modifier None Typical Low $56.23 Median $64.57 Typical High $97.72 | Professional | None | $56.23 | $64.57 | $97.72 |
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 $26.92 Median $32.36 Typical High $32.36 | Professional | 52 · Reduced service | $26.92 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $12.88 Typical High $12.88 | Professional | 53 · Discontinued | $10.72 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $9.55 Typical High $9.55 | Professional | 55 · Aftercare only | $7.94 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $6.46 Typical High $6.46 | Professional | 56 · Pre-op care only | $5.37 | $6.46 | $6.46 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.92 Median $6.92 Typical High $9.12 | Professional | RR · Rental | $6.92 | $6.92 | $9.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | UE · Used equipment | $52.48 | $52.48 | $52.48 |
Where Virginia sits
The same service costs 2.2 times more in Hawaii than in Alabama. 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
$69.18
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.