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 $33.11 Median $33.11 Typical High $33.88 | Facility | None | $33.11 | $33.11 | $33.88 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $33.11 Typical High $33.88 | Professional | None | $30.90 | $33.11 | $33.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $67.61 | Facility | None | $64.57 | $64.57 | $67.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $38.02 | Professional | None | $33.11 | $33.11 | $38.02 |
CareFirst Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $43.65 | Professional | None | $33.88 | $33.88 | $43.65 |
Cigna Setting Facility Modifier None Typical Low $23.99 Median $34.67 Typical High $34.67 | Facility | None | $23.99 | $34.67 | $34.67 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $34.67 | Professional | None | $25.12 | $25.12 | $34.67 |
Kaiser Permanente Setting Professional Modifier None Typical Low $44.67 Median $64.57 Typical High $83.18 | Professional | None | $44.67 | $64.57 | $83.18 |
Medcost Setting Professional Modifier None Typical Low $38.02 Median $41.69 Typical High $58.88 | Professional | None | $38.02 | $41.69 | $58.88 |
Medcost Setting Facility Modifier None Typical Low $19.50 Median $34.67 Typical High $41.69 | Facility | None | $19.50 | $34.67 | $41.69 |
Medcost Setting Professional Modifier None Typical Low $28.84 Median $34.67 Typical High $41.69 | Professional | None | $28.84 | $34.67 | $41.69 |
Sentara Setting Facility Modifier None Typical Low $31.62 Median $44.67 Typical High $138.04 | Facility | None | $31.62 | $44.67 | $138.04 |
Sentara Setting Professional Modifier None Typical Low $34.67 Median $47.86 Typical High $97.72 | Professional | None | $34.67 | $47.86 | $97.72 |
United Setting Facility Modifier None Typical Low $27.54 Median $29.51 Typical High $75.86 | Facility | None | $27.54 | $29.51 | $75.86 |
United Setting Professional Modifier None Typical Low $28.18 Median $31.62 Typical High $47.86 | Professional | None | $28.18 | $31.62 | $47.86 |
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 $15.85 Median $16.60 Typical High $16.98 | Professional | 52 · Reduced service | $15.85 | $16.60 | $16.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.61 Typical High $6.76 | Professional | 53 · Discontinued | $6.31 | $6.61 | $6.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $5.01 Typical High $5.01 | Professional | 55 · Aftercare only | $4.68 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.31 Typical High $3.39 | Professional | 56 · Pre-op care only | $3.16 | $3.31 | $3.39 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.47 Median $3.47 Typical High $4.27 | Professional | RR · Rental | $3.47 | $3.47 | $4.27 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $25.12 Median $25.70 Typical High $26.92 | Professional | UE · Used equipment | $25.12 | $25.70 | $26.92 |
Where Virginia sits
The same service costs 2.5 times more in Hawaii than in Delaware. 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
$33.88
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.