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 $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $54.95 Typical High $54.95 | Professional | None | $46.77 | $54.95 | $54.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $112.20 | Facility | None | $104.71 | $104.71 | $112.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $57.54 | Professional | None | $51.29 | $51.29 | $57.54 |
CareFirst Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $72.44 | Professional | None | $56.23 | $56.23 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $50.12 Typical High $50.12 | Facility | None | $33.88 | $50.12 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $50.12 | Professional | None | $37.15 | $37.15 | $50.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $74.13 Median $104.71 Typical High $138.04 | Professional | None | $74.13 | $104.71 | $138.04 |
Medcost Setting Professional Modifier None Typical Low $63.10 Median $69.18 Typical High $97.72 | Professional | None | $63.10 | $69.18 | $97.72 |
Medcost Setting Facility Modifier None Typical Low $27.54 Median $56.23 Typical High $69.18 | Facility | None | $27.54 | $56.23 | $69.18 |
Medcost Setting Professional Modifier None Typical Low $40.74 Median $53.70 Typical High $69.18 | Professional | None | $40.74 | $53.70 | $69.18 |
Sentara Setting Facility Modifier None Typical Low $51.29 Median $74.13 Typical High $229.09 | Facility | None | $51.29 | $74.13 | $229.09 |
Sentara Setting Professional Modifier None Typical Low $56.23 Median $77.62 Typical High $158.49 | Professional | None | $56.23 | $77.62 | $158.49 |
United Setting Facility Modifier None Typical Low $32.36 Median $38.90 Typical High $104.71 | Facility | None | $32.36 | $38.90 | $104.71 |
United Setting Professional Modifier None Typical Low $43.65 Median $51.29 Typical High $77.62 | Professional | None | $43.65 | $51.29 | $77.62 |
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 $23.44 Median $27.54 Typical High $27.54 | Professional | 52 · Reduced service | $23.44 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $10.96 Typical High $10.96 | Professional | 53 · Discontinued | $9.33 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $8.13 Typical High $8.32 | Professional | 55 · Aftercare only | $7.08 | $8.13 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $5.50 Typical High $5.50 | Professional | 56 · Pre-op care only | $4.68 | $5.50 | $5.50 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.25 Median $5.25 Typical High $6.17 | Professional | RR · Rental | $5.25 | $5.25 | $6.17 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $38.02 Median $38.90 Typical High $41.69 | Professional | UE · Used equipment | $38.02 | $38.90 | $41.69 |
Where Virginia sits
The same service costs 2.1 times more in Arkansas 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· 27th of 51
$52.48
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.