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 $199.53 Median $199.53 Typical High $204.17 | Facility | None | $199.53 | $199.53 | $204.17 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $199.53 Typical High $204.17 | Professional | None | $186.21 | $199.53 | $204.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $407.38 | Facility | None | $389.05 | $389.05 | $407.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $245.47 | Professional | None | $213.80 | $213.80 | $245.47 |
CareFirst Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $263.03 | Professional | None | $204.17 | $204.17 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $269.15 Typical High $269.15 | Facility | None | $204.17 | $269.15 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $269.15 | Professional | None | $199.53 | $199.53 | $269.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $269.15 Median $389.05 Typical High $501.19 | Professional | None | $269.15 | $389.05 | $501.19 |
Medcost Setting Professional Modifier None Typical Low $229.09 Median $251.19 Typical High $354.81 | Professional | None | $229.09 | $251.19 | $354.81 |
Medcost Setting Facility Modifier None Typical Low $120.23 Median $208.93 Typical High $251.19 | Facility | None | $120.23 | $208.93 | $251.19 |
Medcost Setting Professional Modifier None Typical Low $158.49 Median $208.93 Typical High $251.19 | Professional | None | $158.49 | $208.93 | $251.19 |
Sentara Setting Facility Modifier None Typical Low $190.55 Median $263.03 Typical High $831.76 | Facility | None | $190.55 | $263.03 | $831.76 |
Sentara Setting Professional Modifier None Typical Low $208.93 Median $288.40 Typical High $588.84 | Professional | None | $208.93 | $288.40 | $588.84 |
United Setting Facility Modifier None Typical Low $158.49 Median $173.78 Typical High $457.09 | Facility | None | $158.49 | $173.78 | $457.09 |
United Setting Professional Modifier None Typical Low $169.82 Median $190.55 Typical High $288.40 | Professional | None | $169.82 | $190.55 | $288.40 |
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 $97.72 Median $100.00 Typical High $102.33 | Professional | 52 · Reduced service | $97.72 | $100.00 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $39.81 Typical High $40.74 | Professional | 53 · Discontinued | $39.81 | $39.81 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $30.20 Typical High $30.20 | Professional | 55 · Aftercare only | $29.51 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.95 Typical High $20.42 | Professional | 56 · Pre-op care only | $19.50 | $19.95 | $20.42 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $21.88 Median $21.88 Typical High $26.92 | Professional | RR · Rental | $21.88 | $21.88 | $26.92 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $162.18 Median $165.96 Typical High $173.78 | Professional | UE · Used equipment | $162.18 | $165.96 | $173.78 |
Where Virginia sits
The same service costs 2.0 times more in Wisconsin than in Colorado. 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· 39th of 51
$214
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.