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 $204.17 Median $204.17 Typical High $208.93 | Facility | None | $204.17 | $204.17 | $208.93 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $204.17 Typical High $239.88 | Professional | None | $177.83 | $204.17 | $239.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $416.87 | Facility | None | $398.11 | $398.11 | $416.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $302.00 | Professional | None | $275.42 | $275.42 | $302.00 |
CareFirst Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $269.15 | Professional | None | $208.93 | $208.93 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $295.12 Typical High $302.00 | Facility | None | $181.97 | $295.12 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $295.12 | Professional | None | $213.80 | $213.80 | $295.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $275.42 Median $398.11 Typical High $512.86 | Professional | None | $275.42 | $398.11 | $512.86 |
Medcost Setting Professional Modifier None Typical Low $234.42 Median $257.04 Typical High $363.08 | Professional | None | $234.42 | $257.04 | $363.08 |
Medcost Setting Facility Modifier None Typical Low $134.90 Median $213.80 Typical High $257.04 | Facility | None | $134.90 | $213.80 | $257.04 |
Medcost Setting Professional Modifier None Typical Low $173.78 Median $213.80 Typical High $257.04 | Professional | None | $173.78 | $213.80 | $257.04 |
Sentara Setting Facility Modifier None Typical Low $194.98 Median $269.15 Typical High $851.14 | Facility | None | $194.98 | $269.15 | $851.14 |
Sentara Setting Professional Modifier None Typical Low $213.80 Median $295.12 Typical High $602.56 | Professional | None | $213.80 | $295.12 | $602.56 |
United Setting Facility Modifier None Typical Low $186.21 Median $229.09 Typical High $251.19 | Facility | None | $186.21 | $229.09 | $251.19 |
United Setting Professional Modifier None Typical Low $181.97 Median $194.98 Typical High $316.23 | Professional | None | $181.97 | $194.98 | $316.23 |
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 $102.33 Median $102.33 Typical High $104.71 | Professional | 52 · Reduced service | $102.33 | $102.33 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $40.74 Typical High $41.69 | Professional | 53 · Discontinued | $40.74 | $40.74 | $41.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | 55 · Aftercare only | $30.90 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $20.89 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $20.89 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $29.51 Median $29.51 Typical High $30.20 | Professional | RR · Rental | $29.51 | $29.51 | $30.20 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $208.93 Median $223.87 Typical High $223.87 | Professional | UE · Used equipment | $208.93 | $223.87 | $223.87 |
Where Virginia sits
The same service costs 2.5 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· 28th of 51
$275
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.