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 $45.71 Median $69.18 Typical High $151.36 | Facility | None | $45.71 | $69.18 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $56.23 Typical High $134.90 | Professional | None | $45.71 | $56.23 | $134.90 |
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 $61.66 Median $61.66 Typical High $69.18 | Professional | None | $61.66 | $61.66 | $69.18 |
CareFirst Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $79.43 | Professional | None | $60.26 | $60.26 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $67.61 Typical High $72.44 | Facility | None | $52.48 | $67.61 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $67.61 | Professional | None | $50.12 | $50.12 | $67.61 |
Kaiser Permanente Setting Professional Modifier None Typical Low $81.28 Median $114.82 Typical High $147.91 | Professional | None | $81.28 | $114.82 | $147.91 |
Medcost Setting Professional Modifier None Typical Low $67.61 Median $75.86 Typical High $104.71 | Professional | None | $67.61 | $75.86 | $104.71 |
Medcost Setting Facility Modifier None Typical Low $35.48 Median $61.66 Typical High $75.86 | Facility | None | $35.48 | $61.66 | $75.86 |
Medcost Setting Professional Modifier None Typical Low $52.48 Median $61.66 Typical High $144.54 | Professional | None | $52.48 | $61.66 | $144.54 |
Sentara Setting Facility Modifier None Typical Low $56.23 Median $79.43 Typical High $245.47 | Facility | None | $56.23 | $79.43 | $245.47 |
Sentara Setting Professional Modifier None Typical Low $61.66 Median $85.11 Typical High $173.78 | Professional | None | $61.66 | $85.11 | $173.78 |
United Setting Facility Modifier None Typical Low $67.61 Median $77.62 Typical High $138.04 | Facility | None | $67.61 | $77.62 | $138.04 |
United Setting Professional Modifier None Typical Low $50.12 Median $56.23 Typical High $85.11 | Professional | None | $50.12 | $56.23 | $85.11 |
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 $4.57 Median $5.62 Typical High $5.62 | Professional | 56 · Pre-op care only | $4.57 | $5.62 | $5.62 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.31 Median $6.31 Typical High $7.94 | Professional | RR · Rental | $6.31 | $6.31 | $7.94 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $45.71 Median $47.86 Typical High $50.12 | Professional | UE · Used equipment | $45.71 | $47.86 | $50.12 |
Where Virginia sits
The same service costs 4.1 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· 37th 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.