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 $14.79 Median $14.79 Typical High $14.79 | Facility | None | $14.79 | $14.79 | $14.79 |
Aetna Setting Professional Modifier None Typical Low $13.18 Median $14.79 Typical High $14.79 | Professional | None | $13.18 | $14.79 | $14.79 |
Anthem BCBS Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $30.20 | Facility | None | $28.18 | $28.18 | $30.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $17.38 | Professional | None | $15.49 | $15.49 | $17.38 |
CareFirst Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $19.50 | Professional | None | $15.14 | $15.14 | $19.50 |
Cigna Setting Facility Modifier None Typical Low $14.79 Median $16.60 Typical High $16.60 | Facility | None | $14.79 | $16.60 | $16.60 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $16.60 | Professional | None | $12.02 | $12.02 | $16.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $19.95 Median $28.18 Typical High $37.15 | Professional | None | $19.95 | $28.18 | $37.15 |
Medcost Setting Professional Modifier None Typical Low $16.60 Median $18.62 Typical High $26.30 | Professional | None | $16.60 | $18.62 | $26.30 |
Medcost Setting Facility Modifier None Typical Low $8.71 Median $15.14 Typical High $18.62 | Facility | None | $8.71 | $15.14 | $18.62 |
Medcost Setting Professional Modifier None Typical Low $13.49 Median $15.14 Typical High $18.62 | Professional | None | $13.49 | $15.14 | $18.62 |
Sentara Setting Facility Modifier None Typical Low $13.80 Median $19.50 Typical High $61.66 | Facility | None | $13.80 | $19.50 | $61.66 |
Sentara Setting Professional Modifier None Typical Low $15.14 Median $20.89 Typical High $42.66 | Professional | None | $15.14 | $20.89 | $42.66 |
United Setting Facility Modifier None Typical Low $12.88 Median $16.22 Typical High $33.88 | Facility | None | $12.88 | $16.22 | $33.88 |
United Setting Professional Modifier None Typical Low $12.59 Median $13.80 Typical High $20.89 | Professional | None | $12.59 | $13.80 | $20.89 |
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 $6.76 Median $7.41 Typical High $7.41 | Professional | 52 · Reduced service | $6.76 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.75 Median $2.95 Typical High $2.95 | Professional | 53 · Discontinued | $2.75 | $2.95 | $2.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.04 Median $2.19 Typical High $2.24 | Professional | 55 · Aftercare only | $2.04 | $2.19 | $2.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.38 Median $1.48 Typical High $1.48 | Professional | 56 · Pre-op care only | $1.38 | $1.48 | $1.48 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.58 Median $1.58 Typical High $2.00 | Professional | RR · Rental | $1.58 | $1.58 | $2.00 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $11.48 Median $12.02 Typical High $12.59 | Professional | UE · Used equipment | $11.48 | $12.02 | $12.59 |
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· 37th of 51
$15.49
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.