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 $40.74 Median $40.74 Typical High $41.69 | Facility | None | $40.74 | $40.74 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $40.74 Typical High $41.69 | Professional | None | $36.31 | $40.74 | $41.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $85.11 | Facility | None | $79.43 | $79.43 | $85.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $44.67 | Professional | None | $38.90 | $38.90 | $44.67 |
CareFirst Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $54.95 | Professional | None | $41.69 | $41.69 | $54.95 |
Cigna Setting Facility Modifier None Typical Low $41.69 Median $44.67 Typical High $44.67 | Facility | None | $41.69 | $44.67 | $44.67 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $44.67 | Professional | None | $33.11 | $33.11 | $44.67 |
Kaiser Permanente Setting Professional Modifier None Typical Low $56.23 Median $79.43 Typical High $102.33 | Professional | None | $56.23 | $79.43 | $102.33 |
Medcost Setting Professional Modifier None Typical Low $46.77 Median $52.48 Typical High $72.44 | Professional | None | $46.77 | $52.48 | $72.44 |
Medcost Setting Facility Modifier None Typical Low $21.88 Median $42.66 Typical High $51.29 | Facility | None | $21.88 | $42.66 | $51.29 |
Medcost Setting Professional Modifier None Typical Low $33.88 Median $42.66 Typical High $51.29 | Professional | None | $33.88 | $42.66 | $51.29 |
Sentara Setting Facility Modifier None Typical Low $38.90 Median $54.95 Typical High $169.82 | Facility | None | $38.90 | $54.95 | $169.82 |
Sentara Setting Professional Modifier None Typical Low $42.66 Median $58.88 Typical High $120.23 | Professional | None | $42.66 | $58.88 | $120.23 |
United Setting Facility Modifier None Typical Low $36.31 Median $37.15 Typical High $83.18 | Facility | None | $36.31 | $37.15 | $83.18 |
United Setting Professional Modifier None Typical Low $33.11 Median $38.90 Typical High $58.88 | Professional | None | $33.11 | $38.90 | $58.88 |
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 $18.20 Median $20.42 Typical High $20.89 | Professional | 52 · Reduced service | $18.20 | $20.42 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $8.13 Typical High $8.32 | Professional | 53 · Discontinued | $7.24 | $8.13 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $6.17 Typical High $6.17 | Professional | 55 · Aftercare only | $5.50 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $4.07 Typical High $4.17 | Professional | 56 · Pre-op care only | $3.63 | $4.07 | $4.17 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.07 Median $4.07 Typical High $5.01 | Professional | RR · Rental | $4.07 | $4.07 | $5.01 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $29.51 Median $30.20 Typical High $31.62 | Professional | UE · Used equipment | $29.51 | $30.20 | $31.62 |
Where Virginia sits
The same service costs 2.5 times more in Hawaii 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· 33rd of 51
$40.74
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.