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 $208.93 Median $208.93 Typical High $213.80 | Facility | None | $208.93 | $208.93 | $213.80 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $213.80 | Professional | None | $208.93 | $208.93 | $213.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $426.58 | Facility | None | $407.38 | $407.38 | $426.58 |
Anthem BCBS Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $295.12 | Professional | None | $239.88 | $239.88 | $295.12 |
CareFirst Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $281.84 | Professional | None | $213.80 | $213.80 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $309.03 Typical High $309.03 | Facility | None | $213.80 | $309.03 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $309.03 | Professional | None | $223.87 | $223.87 | $309.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $281.84 Median $407.38 Typical High $524.81 | Professional | None | $281.84 | $407.38 | $524.81 |
Medcost Setting Professional Modifier None Typical Low $239.88 Median $263.03 Typical High $371.54 | Professional | None | $239.88 | $263.03 | $371.54 |
Medcost Setting Facility Modifier None Typical Low $141.25 Median $218.78 Typical High $263.03 | Facility | None | $141.25 | $218.78 | $263.03 |
Medcost Setting Professional Modifier None Typical Low $190.55 Median $223.87 Typical High $263.03 | Professional | None | $190.55 | $223.87 | $263.03 |
Sentara Setting Facility Modifier None Typical Low $199.53 Median $275.42 Typical High $870.96 | Facility | None | $199.53 | $275.42 | $870.96 |
Sentara Setting Professional Modifier None Typical Low $218.78 Median $302.00 Typical High $616.60 | Professional | None | $218.78 | $302.00 | $616.60 |
United Setting Facility Modifier None Typical Low $218.78 Median $245.47 Typical High $537.03 | Facility | None | $218.78 | $245.47 | $537.03 |
United Setting Professional Modifier None Typical Low $186.21 Median $199.53 Typical High $309.03 | Professional | None | $186.21 | $199.53 | $309.03 |
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 $104.71 Median $104.71 Typical High $107.15 | Professional | 52 · Reduced service | $104.71 | $104.71 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $42.66 | Professional | 53 · Discontinued | $41.69 | $41.69 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | 55 · Aftercare only | $31.62 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $21.38 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $21.38 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $23.99 Median $23.99 Typical High $31.62 | Professional | RR · Rental | $23.99 | $23.99 | $31.62 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $181.97 Median $181.97 Typical High $194.98 | Professional | UE · Used equipment | $181.97 | $181.97 | $194.98 |
Where Virginia sits
The same service costs 2.5 times more in Hawaii than in Pennsylvania. 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· 36th of 51
$240
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.