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 $10.96 Median $10.96 Typical High $11.22 | Facility | None | $10.96 | $10.96 | $11.22 |
Aetna Setting Professional Modifier None Typical Low $10.23 Median $10.96 Typical High $11.22 | Professional | None | $10.23 | $10.96 | $11.22 |
Anthem BCBS Setting Facility Modifier None Typical Low $21.38 Median $21.38 Typical High $22.39 | Facility | None | $21.38 | $21.38 | $22.39 |
Anthem BCBS Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $15.14 | Professional | None | $13.49 | $13.49 | $15.14 |
CareFirst Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $14.45 | Professional | None | $10.96 | $10.96 | $14.45 |
Cigna Setting Facility Modifier None Typical Low $11.22 Median $14.45 Typical High $14.45 | Facility | None | $11.22 | $14.45 | $14.45 |
Cigna Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $14.45 | Professional | None | $10.47 | $10.47 | $14.45 |
Kaiser Permanente Setting Professional Modifier None Typical Low $14.79 Median $21.38 Typical High $27.54 | Professional | None | $14.79 | $21.38 | $27.54 |
Medcost Setting Professional Modifier None Typical Low $12.59 Median $13.80 Typical High $19.50 | Professional | None | $12.59 | $13.80 | $19.50 |
Medcost Setting Facility Modifier None Typical Low $6.76 Median $11.48 Typical High $13.80 | Facility | None | $6.76 | $11.48 | $13.80 |
Medcost Setting Professional Modifier None Typical Low $11.22 Median $12.88 Typical High $15.14 | Professional | None | $11.22 | $12.88 | $15.14 |
Sentara Setting Facility Modifier None Typical Low $10.47 Median $14.45 Typical High $45.71 | Facility | None | $10.47 | $14.45 | $45.71 |
Sentara Setting Professional Modifier None Typical Low $11.48 Median $15.49 Typical High $32.36 | Professional | None | $11.48 | $15.49 | $32.36 |
United Setting Facility Modifier None Typical Low $12.59 Median $12.88 Typical High $25.70 | Facility | None | $12.59 | $12.88 | $25.70 |
United Setting Professional Modifier None Typical Low $9.33 Median $10.47 Typical High $15.85 | Professional | None | $9.33 | $10.47 | $15.85 |
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 $5.37 Median $5.50 Typical High $5.62 | Professional | 52 · Reduced service | $5.37 | $5.50 | $5.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.14 Median $2.19 Typical High $2.24 | Professional | 53 · Discontinued | $2.14 | $2.19 | $2.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.62 Median $1.66 Typical High $1.66 | Professional | 55 · Aftercare only | $1.62 | $1.66 | $1.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.07 Median $1.10 Typical High $1.12 | Professional | 56 · Pre-op care only | $1.07 | $1.10 | $1.12 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.41 Median $1.41 Typical High $1.51 | Professional | RR · Rental | $1.41 | $1.41 | $1.51 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $10.23 Median $10.47 Typical High $10.96 | Professional | UE · Used equipment | $10.23 | $10.47 | $10.96 |
Where Virginia sits
The same service costs 3.0 times more in Hawaii than in Delaware. 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· 31st of 51
$13.49
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.