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 $97.72 Median $97.72 Typical High $181.97 | Facility | None | $97.72 | $97.72 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $181.97 | Professional | None | $97.72 | $97.72 | $181.97 |
Anthem BCBS Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $77.62 | Professional | None | $58.88 | $58.88 | $77.62 |
CareFirst Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $147.91 | Professional | None | $50.12 | $50.12 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $19.50 Median $20.89 Typical High $37.15 | Facility | None | $19.50 | $20.89 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $151.36 Median $169.82 Typical High $169.82 | Professional | None | $151.36 | $169.82 | $169.82 |
Medcost Setting Facility Modifier None Typical Low $97.72 Median $147.91 Typical High $181.97 | Facility | None | $97.72 | $147.91 | $181.97 |
Sentara Setting Facility Modifier None Typical Low $34.67 Median $50.12 Typical High $218.78 | Facility | None | $34.67 | $50.12 | $218.78 |
Sentara Setting Professional Modifier None Typical Low $34.67 Median $50.12 Typical High $93.33 | Professional | None | $34.67 | $50.12 | $93.33 |
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 $48.98 Median $48.98 Typical High $91.20 | Professional | 52 · Reduced service | $48.98 | $48.98 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $19.50 Typical High $36.31 | Professional | 53 · Discontinued | $19.50 | $19.50 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $14.45 Typical High $27.54 | Professional | 55 · Aftercare only | $14.45 | $14.45 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $9.77 Typical High $18.20 | Professional | 56 · Pre-op care only | $9.77 | $9.77 | $18.20 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.89 Median $5.89 Typical High $5.89 | Professional | RR · Rental | $5.89 | $5.89 | $5.89 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $42.66 Median $44.67 Typical High $44.67 | Professional | UE · Used equipment | $42.66 | $44.67 | $44.67 |
Where Virginia sits
The same service costs 26.3 times more in Rhode Island than in South Carolina. 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· 33rd of 51
$61.66
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.