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 $107.15 Median $107.15 Typical High $109.65 | Facility | None | $107.15 | $107.15 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $109.65 | Professional | None | $107.15 | $107.15 | $109.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $218.78 | Facility | None | $208.93 | $208.93 | $218.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $141.25 | Professional | None | $123.03 | $123.03 | $141.25 |
CareFirst Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $144.54 | Professional | None | $109.65 | $109.65 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $169.82 Typical High $169.82 | Facility | None | $104.71 | $169.82 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $169.82 | Professional | None | $123.03 | $123.03 | $169.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $144.54 Median $208.93 Typical High $269.15 | Professional | None | $144.54 | $208.93 | $269.15 |
Medcost Setting Professional Modifier None Typical Low $123.03 Median $134.90 Typical High $190.55 | Professional | None | $123.03 | $134.90 | $190.55 |
Medcost Setting Facility Modifier None Typical Low $72.44 Median $112.20 Typical High $134.90 | Facility | None | $72.44 | $112.20 | $134.90 |
Medcost Setting Professional Modifier None Typical Low $112.20 Median $114.82 Typical High $162.18 | Professional | None | $112.20 | $114.82 | $162.18 |
Sentara Setting Facility Modifier None Typical Low $102.33 Median $141.25 Typical High $446.68 | Facility | None | $102.33 | $141.25 | $446.68 |
Sentara Setting Professional Modifier None Typical Low $112.20 Median $154.88 Typical High $316.23 | Professional | None | $112.20 | $154.88 | $316.23 |
United Setting Facility Modifier None Typical Low $107.15 Median $134.90 Typical High $275.42 | Facility | None | $107.15 | $134.90 | $275.42 |
United Setting Professional Modifier None Typical Low $95.50 Median $102.33 Typical High $158.49 | Professional | None | $95.50 | $102.33 | $158.49 |
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 $53.70 Median $53.70 Typical High $54.95 | Professional | 52 · Reduced service | $53.70 | $53.70 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.38 Typical High $21.88 | Professional | 53 · Discontinued | $21.38 | $21.38 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | 55 · Aftercare only | $16.22 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.72 Typical High $10.96 | Professional | 56 · Pre-op care only | $10.72 | $10.72 | $10.96 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $12.88 Median $12.88 Typical High $16.22 | Professional | RR · Rental | $12.88 | $12.88 | $16.22 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $93.33 Median $95.50 Typical High $100.00 | Professional | UE · Used equipment | $93.33 | $95.50 | $100.00 |
Where Virginia sits
The same service costs 2.7 times more in Hawaii than in Washington, DC. 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· 46th of 51
$123
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.