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 $46.77 Median $46.77 Typical High $46.77 | Facility | None | $46.77 | $46.77 | $46.77 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $46.77 Typical High $46.77 | Professional | None | $44.67 | $46.77 | $46.77 |
Anthem BCBS Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $95.50 | Facility | None | $91.20 | $91.20 | $95.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $61.66 | Professional | None | $54.95 | $54.95 | $61.66 |
CareFirst Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $61.66 | Professional | None | $48.98 | $48.98 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $47.86 Median $50.12 Typical High $50.12 | Facility | None | $47.86 | $50.12 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $50.12 | Professional | None | $37.15 | $37.15 | $50.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $63.10 Median $91.20 Typical High $117.49 | Professional | None | $63.10 | $91.20 | $117.49 |
Medcost Setting Professional Modifier None Typical Low $53.70 Median $58.88 Typical High $83.18 | Professional | None | $53.70 | $58.88 | $83.18 |
Medcost Setting Facility Modifier None Typical Low $28.84 Median $48.98 Typical High $58.88 | Facility | None | $28.84 | $48.98 | $58.88 |
Medcost Setting Professional Modifier None Typical Low $48.98 Median $51.29 Typical High $58.88 | Professional | None | $48.98 | $51.29 | $58.88 |
Sentara Setting Facility Modifier None Typical Low $43.65 Median $64.57 Typical High $194.98 | Facility | None | $43.65 | $64.57 | $194.98 |
Sentara Setting Professional Modifier None Typical Low $48.98 Median $69.18 Typical High $134.90 | Professional | None | $48.98 | $69.18 | $134.90 |
United Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $131.83 | Facility | None | $44.67 | $44.67 | $131.83 |
United Setting Professional Modifier None Typical Low $40.74 Median $44.67 Typical High $66.07 | Professional | None | $40.74 | $44.67 | $66.07 |
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 $22.39 Median $23.44 Typical High $23.44 | Professional | 52 · Reduced service | $22.39 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $9.33 Typical High $9.33 | Professional | 53 · Discontinued | $8.91 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $7.08 Typical High $7.08 | Professional | 55 · Aftercare only | $6.61 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $4.68 Typical High $4.68 | Professional | 56 · Pre-op care only | $4.47 | $4.68 | $4.68 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.62 Median $5.62 Typical High $6.46 | Professional | RR · Rental | $5.62 | $5.62 | $6.46 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $40.74 Median $41.69 Typical High $44.67 | Professional | UE · Used equipment | $40.74 | $41.69 | $44.67 |
Where Virginia sits
The same service costs 2.8 times more in Kansas 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· 29th of 51
$54.95
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.