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 $37.15 Median $44.67 Typical High $44.67 | Facility | None | $37.15 | $44.67 | $44.67 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $44.67 Typical High $56.23 | Professional | None | $37.15 | $44.67 | $56.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $97.72 | Facility | None | $93.33 | $93.33 | $97.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $56.23 | Professional | None | $48.98 | $48.98 | $56.23 |
CareFirst Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $63.10 | Professional | None | $51.29 | $51.29 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $39.81 Median $56.23 Typical High $64.57 | Facility | None | $39.81 | $56.23 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $56.23 | Professional | None | $41.69 | $41.69 | $56.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $64.57 Median $93.33 Typical High $120.23 | Professional | None | $64.57 | $93.33 | $120.23 |
Medcost Setting Professional Modifier None Typical Low $54.95 Median $60.26 Typical High $85.11 | Professional | None | $54.95 | $60.26 | $85.11 |
Medcost Setting Facility Modifier None Typical Low $29.51 Median $50.12 Typical High $60.26 | Facility | None | $29.51 | $50.12 | $60.26 |
Medcost Setting Professional Modifier None Typical Low $50.12 Median $56.23 Typical High $114.82 | Professional | None | $50.12 | $56.23 | $114.82 |
Sentara Setting Facility Modifier None Typical Low $44.67 Median $64.57 Typical High $199.53 | Facility | None | $44.67 | $64.57 | $199.53 |
Sentara Setting Professional Modifier None Typical Low $50.12 Median $69.18 Typical High $141.25 | Professional | None | $50.12 | $69.18 | $141.25 |
United Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $134.90 | Facility | None | $44.67 | $44.67 | $134.90 |
United Setting Professional Modifier None Typical Low $40.74 Median $45.71 Typical High $67.61 | Professional | None | $40.74 | $45.71 | $67.61 |
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 $18.62 Median $22.39 Typical High $22.39 | Professional | 52 · Reduced service | $18.62 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $8.91 Typical High $8.91 | Professional | 53 · Discontinued | $7.41 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $6.76 Typical High $6.76 | Professional | 55 · Aftercare only | $5.62 | $6.76 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $4.47 Typical High $4.47 | Professional | 56 · Pre-op care only | $3.72 | $4.47 | $4.47 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.13 Median $5.13 Typical High $6.61 | Professional | RR · Rental | $5.13 | $5.13 | $6.61 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $37.15 Median $38.02 Typical High $38.02 | Professional | UE · Used equipment | $37.15 | $38.02 | $38.02 |
Where Virginia sits
The same service costs 2.6 times more in Kansas than in Arizona. 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
$48.98
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.