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 $79.43 Median $79.43 Typical High $81.28 | Facility | None | $79.43 | $79.43 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $79.43 Typical High $81.28 | Professional | None | $75.86 | $79.43 | $81.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $162.18 | Facility | None | $154.88 | $154.88 | $162.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $104.71 | Professional | None | $93.33 | $93.33 | $104.71 |
CareFirst Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $104.71 | Professional | None | $85.11 | $85.11 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $100.00 Typical High $100.00 | Facility | None | $66.07 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $100.00 | Professional | None | $72.44 | $72.44 | $100.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $107.15 Median $154.88 Typical High $199.53 | Professional | None | $107.15 | $154.88 | $199.53 |
Medcost Setting Professional Modifier None Typical Low $77.62 Median $100.00 Typical High $141.25 | Professional | None | $77.62 | $100.00 | $141.25 |
Medcost Setting Facility Modifier None Typical Low $48.98 Median $83.18 Typical High $100.00 | Facility | None | $48.98 | $83.18 | $100.00 |
Medcost Setting Professional Modifier None Typical Low $83.18 Median $93.33 Typical High $109.65 | Professional | None | $83.18 | $93.33 | $109.65 |
Sentara Setting Facility Modifier None Typical Low $74.13 Median $112.20 Typical High $446.68 | Facility | None | $74.13 | $112.20 | $446.68 |
Sentara Setting Professional Modifier None Typical Low $79.43 Median $117.49 Typical High $234.42 | Professional | None | $79.43 | $117.49 | $234.42 |
United Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $223.87 | Facility | None | $186.21 | $186.21 | $223.87 |
United Setting Professional Modifier None Typical Low $69.18 Median $75.86 Typical High $112.20 | Professional | None | $69.18 | $75.86 | $112.20 |
4 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 55 · Aftercare only Typical Low $11.22 Median $12.02 Typical High $12.02 | Professional | 55 · Aftercare only | $11.22 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.94 Typical High $7.94 | Professional | 56 · Pre-op care only | $7.59 | $7.94 | $7.94 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $9.55 Median $9.55 Typical High $10.96 | Professional | RR · Rental | $9.55 | $9.55 | $10.96 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $69.18 Median $72.44 Typical High $75.86 | Professional | UE · Used equipment | $69.18 | $72.44 | $75.86 |
Where Virginia sits
The same service costs 2.2 times more in Montana than in Florida. 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· 32nd of 51
$93.33
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.