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 $123.03 Median $123.03 Typical High $125.89 | Facility | None | $123.03 | $123.03 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $125.89 | Professional | None | $123.03 | $123.03 | $125.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $257.04 | Facility | None | $239.88 | $239.88 | $257.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $169.82 | Professional | None | $138.04 | $138.04 | $169.82 |
CareFirst Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $165.96 | Professional | None | $125.89 | $125.89 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $158.49 Typical High $158.49 | Facility | None | $107.15 | $158.49 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $158.49 | Professional | None | $117.49 | $117.49 | $158.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $169.82 Median $239.88 Typical High $309.03 | Professional | None | $169.82 | $239.88 | $309.03 |
Medcost Setting Professional Modifier None Typical Low $147.91 Median $158.49 Typical High $218.78 | Professional | None | $147.91 | $158.49 | $218.78 |
Medcost Setting Facility Modifier None Typical Low $79.43 Median $128.82 Typical High $158.49 | Facility | None | $79.43 | $128.82 | $158.49 |
Medcost Setting Professional Modifier None Typical Low $100.00 Median $128.82 Typical High $158.49 | Professional | None | $100.00 | $128.82 | $158.49 |
Sentara Setting Facility Modifier None Typical Low $117.49 Median $165.96 Typical High $512.86 | Facility | None | $117.49 | $165.96 | $512.86 |
Sentara Setting Professional Modifier None Typical Low $128.82 Median $177.83 Typical High $363.08 | Professional | None | $128.82 | $177.83 | $363.08 |
United Setting Facility Modifier None Typical Low $107.15 Median $131.83 Typical High $302.00 | Facility | None | $107.15 | $131.83 | $302.00 |
United Setting Professional Modifier None Typical Low $109.65 Median $117.49 Typical High $177.83 | Professional | None | $109.65 | $117.49 | $177.83 |
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 $61.66 Median $61.66 Typical High $63.10 | Professional | 52 · Reduced service | $61.66 | $61.66 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | 53 · Discontinued | $25.12 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | 55 · Aftercare only | $18.62 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.30 Typical High $12.59 | Professional | 56 · Pre-op care only | $12.30 | $12.30 | $12.59 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $13.80 Median $13.80 Typical High $17.78 | Professional | RR · Rental | $13.80 | $13.80 | $17.78 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $102.33 Median $102.33 Typical High $112.20 | Professional | UE · Used equipment | $102.33 | $102.33 | $112.20 |
Where Virginia sits
The same service costs 2.4 times more in Hawaii than in New Jersey. 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
$138
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.