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 $22.91 Median $22.91 Typical High $23.44 | Facility | None | $22.91 | $22.91 | $23.44 |
Aetna Setting Professional Modifier None Typical Low $22.39 Median $22.91 Typical High $28.18 | Professional | None | $22.39 | $22.91 | $28.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $47.86 | Facility | None | $44.67 | $44.67 | $47.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $40.74 | Professional | None | $32.36 | $32.36 | $40.74 |
CareFirst Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $30.90 | Professional | None | $24.55 | $24.55 | $30.90 |
Cigna Setting Facility Modifier None Typical Low $21.88 Median $34.67 Typical High $34.67 | Facility | None | $21.88 | $34.67 | $34.67 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $34.67 | Professional | None | $25.70 | $25.70 | $34.67 |
Kaiser Permanente Setting Professional Modifier None Typical Low $31.62 Median $44.67 Typical High $57.54 | Professional | None | $31.62 | $44.67 | $57.54 |
Medcost Setting Professional Modifier None Typical Low $26.30 Median $29.51 Typical High $40.74 | Professional | None | $26.30 | $29.51 | $40.74 |
Medcost Setting Facility Modifier None Typical Low $15.49 Median $23.99 Typical High $28.84 | Facility | None | $15.49 | $23.99 | $28.84 |
Medcost Setting Professional Modifier None Typical Low $19.95 Median $23.99 Typical High $30.20 | Professional | None | $19.95 | $23.99 | $30.20 |
Sentara Setting Facility Modifier None Typical Low $21.88 Median $30.20 Typical High $93.33 | Facility | None | $21.88 | $30.20 | $93.33 |
Sentara Setting Professional Modifier None Typical Low $23.99 Median $33.11 Typical High $67.61 | Professional | None | $23.99 | $33.11 | $67.61 |
United Setting Facility Modifier None Typical Low $16.22 Median $29.51 Typical High $31.62 | Facility | None | $16.22 | $29.51 | $31.62 |
United Setting Professional Modifier None Typical Low $20.42 Median $21.88 Typical High $35.48 | Professional | None | $20.42 | $21.88 | $35.48 |
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 $11.48 Median $11.48 Typical High $11.75 | Professional | 52 · Reduced service | $11.48 | $11.48 | $11.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.57 Median $4.57 Typical High $4.68 | Professional | 53 · Discontinued | $4.57 | $4.57 | $4.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | 55 · Aftercare only | $3.47 | $3.47 | $3.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.29 Median $2.29 Typical High $2.34 | Professional | 56 · Pre-op care only | $2.29 | $2.29 | $2.34 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.47 Median $4.07 Typical High $4.07 | Professional | RR · Rental | $3.47 | $4.07 | $4.07 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $24.55 Median $30.20 Typical High $30.20 | Professional | UE · Used equipment | $24.55 | $30.20 | $30.20 |
Where Virginia sits
The same service costs 3.2 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· 27th of 51
$32.36
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.