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 $81.28 Median $97.72 Typical High $97.72 | Facility | None | $81.28 | $97.72 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $97.72 Typical High $125.89 | Professional | None | $81.28 | $97.72 | $125.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $213.80 | Facility | None | $199.53 | $199.53 | $213.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $123.03 | Professional | None | $109.65 | $109.65 | $123.03 |
CareFirst Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $138.04 | Professional | None | $109.65 | $109.65 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $112.20 Typical High $112.20 | Facility | None | $87.10 | $112.20 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $112.20 | Professional | None | $83.18 | $83.18 | $112.20 |
Kaiser Permanente Setting Professional Modifier None Typical Low $141.25 Median $199.53 Typical High $263.03 | Professional | None | $141.25 | $199.53 | $263.03 |
Medcost Setting Professional Modifier None Typical Low $117.49 Median $131.83 Typical High $186.21 | Professional | None | $117.49 | $131.83 | $186.21 |
Medcost Setting Facility Modifier None Typical Low $64.57 Median $107.15 Typical High $131.83 | Facility | None | $64.57 | $107.15 | $131.83 |
Medcost Setting Professional Modifier None Typical Low $107.15 Median $123.03 Typical High $251.19 | Professional | None | $107.15 | $123.03 | $251.19 |
Sentara Setting Facility Modifier None Typical Low $97.72 Median $144.54 Typical High $436.52 | Facility | None | $97.72 | $144.54 | $436.52 |
Sentara Setting Professional Modifier None Typical Low $107.15 Median $151.36 Typical High $302.00 | Professional | None | $107.15 | $151.36 | $302.00 |
United Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $295.12 | Facility | None | $97.72 | $97.72 | $295.12 |
United Setting Professional Modifier None Typical Low $89.13 Median $97.72 Typical High $147.91 | Professional | None | $89.13 | $97.72 | $147.91 |
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 $40.74 Median $48.98 Typical High $48.98 | Professional | 52 · Reduced service | $40.74 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $19.50 Typical High $19.50 | Professional | 53 · Discontinued | $16.22 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $14.79 Typical High $14.79 | Professional | 55 · Aftercare only | $12.02 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $9.77 Typical High $9.77 | Professional | 56 · Pre-op care only | $8.13 | $9.77 | $9.77 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $11.22 Median $11.22 Typical High $14.45 | Professional | RR · Rental | $11.22 | $11.22 | $14.45 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $81.28 Median $85.11 Typical High $89.13 | Professional | UE · Used equipment | $81.28 | $85.11 | $89.13 |
Where Virginia sits
The same service costs 2.3 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· 41st of 51
$110
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.