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 $83.18 Median $83.18 Typical High $85.11 | Facility | None | $83.18 | $83.18 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $83.18 Typical High $85.11 | Professional | None | $77.62 | $83.18 | $85.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $173.78 | Facility | None | $162.18 | $162.18 | $173.78 |
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 $112.20 | Professional | None | $85.11 | $85.11 | $112.20 |
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 $114.82 Median $162.18 Typical High $213.80 | Professional | None | $114.82 | $162.18 | $213.80 |
Medcost Setting Professional Modifier None Typical Low $102.33 Median $107.15 Typical High $147.91 | Professional | None | $102.33 | $107.15 | $147.91 |
Medcost Setting Facility Modifier None Typical Low $54.95 Median $87.10 Typical High $107.15 | Facility | None | $54.95 | $87.10 | $107.15 |
Medcost Setting Professional Modifier None Typical Low $72.44 Median $87.10 Typical High $107.15 | Professional | None | $72.44 | $87.10 | $107.15 |
Sentara Setting Facility Modifier None Typical Low $77.62 Median $112.20 Typical High $346.74 | Facility | None | $77.62 | $112.20 | $346.74 |
Sentara Setting Professional Modifier None Typical Low $87.10 Median $120.23 Typical High $245.47 | Professional | None | $87.10 | $120.23 | $245.47 |
United Setting Facility Modifier None Typical Low $60.26 Median $75.86 Typical High $208.93 | Facility | None | $60.26 | $75.86 | $208.93 |
United Setting Professional Modifier None Typical Low $74.13 Median $79.43 Typical High $120.23 | Professional | None | $74.13 | $79.43 | $120.23 |
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 $41.69 Median $41.69 Typical High $42.66 | Professional | 52 · Reduced service | $41.69 | $41.69 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | 53 · Discontinued | $16.98 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $12.88 | Professional | 55 · Aftercare only | $12.59 | $12.59 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $8.51 | Professional | 56 · Pre-op care only | $8.32 | $8.32 | $8.51 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $9.55 Median $9.55 Typical High $11.75 | Professional | RR · Rental | $9.55 | $9.55 | $11.75 |
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 2.9 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· 37th 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.