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 $41.69 Median $51.29 Typical High $51.29 | Facility | None | $41.69 | $51.29 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $51.29 Typical High $52.48 | Professional | None | $41.69 | $51.29 | $52.48 |
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 $61.66 Median $61.66 Typical High $75.86 | Professional | None | $61.66 | $61.66 | $75.86 |
CareFirst Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $72.44 | Professional | None | $54.95 | $54.95 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $66.07 Typical High $66.07 | Facility | None | $43.65 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $66.07 | Professional | None | $48.98 | $48.98 | $66.07 |
Kaiser Permanente Setting Professional Modifier None Typical Low $72.44 Median $104.71 Typical High $134.90 | Professional | None | $72.44 | $104.71 | $134.90 |
Medcost Setting Professional Modifier None Typical Low $64.57 Median $69.18 Typical High $95.50 | Professional | None | $64.57 | $69.18 | $95.50 |
Medcost Setting Facility Modifier None Typical Low $36.31 Median $56.23 Typical High $67.61 | Facility | None | $36.31 | $56.23 | $67.61 |
Medcost Setting Professional Modifier None Typical Low $53.70 Median $60.26 Typical High $131.83 | Professional | None | $53.70 | $60.26 | $131.83 |
Sentara Setting Facility Modifier None Typical Low $51.29 Median $72.44 Typical High $223.87 | Facility | None | $51.29 | $72.44 | $223.87 |
Sentara Setting Professional Modifier None Typical Low $56.23 Median $77.62 Typical High $158.49 | Professional | None | $56.23 | $77.62 | $158.49 |
United Setting Facility Modifier None Typical Low $46.77 Median $61.66 Typical High $138.04 | Facility | None | $46.77 | $61.66 | $138.04 |
United Setting Professional Modifier None Typical Low $46.77 Median $51.29 Typical High $77.62 | Professional | None | $46.77 | $51.29 | $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 $20.89 Median $25.12 Typical High $26.30 | Professional | 52 · Reduced service | $20.89 | $25.12 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $10.23 Typical High $10.47 | Professional | 53 · Discontinued | $8.32 | $10.23 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $7.59 Typical High $7.94 | Professional | 55 · Aftercare only | $6.31 | $7.59 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $5.13 Typical High $5.25 | Professional | 56 · Pre-op care only | $4.17 | $5.13 | $5.25 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.17 Median $6.17 Typical High $8.13 | Professional | RR · Rental | $6.17 | $6.17 | $8.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | UE · Used equipment | $46.77 | $46.77 | $46.77 |
Where Virginia sits
The same service costs 2.7 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· 33rd of 51
$61.66
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.