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 $12.88 Median $12.88 Typical High $13.18 | Facility | None | $12.88 | $12.88 | $13.18 |
Aetna Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $13.18 | Professional | None | $12.88 | $12.88 | $13.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $25.12 Median $25.12 Typical High $26.92 | Facility | None | $25.12 | $25.12 | $26.92 |
Anthem BCBS Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $19.50 | Professional | None | $17.78 | $17.78 | $19.50 |
CareFirst Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $17.38 | Professional | None | $12.88 | $12.88 | $17.38 |
Cigna Setting Facility Modifier None Typical Low $13.18 Median $16.22 Typical High $16.22 | Facility | None | $13.18 | $16.22 | $16.22 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $16.22 | Professional | None | $12.02 | $12.02 | $16.22 |
Kaiser Permanente Setting Professional Modifier None Typical Low $17.38 Median $25.12 Typical High $32.36 | Professional | None | $17.38 | $25.12 | $32.36 |
Medcost Setting Professional Modifier None Typical Low $14.79 Median $16.60 Typical High $22.91 | Professional | None | $14.79 | $16.60 | $22.91 |
Medcost Setting Facility Modifier None Typical Low $8.32 Median $13.49 Typical High $16.22 | Facility | None | $8.32 | $13.49 | $16.22 |
Medcost Setting Professional Modifier None Typical Low $12.02 Median $16.22 Typical High $16.98 | Professional | None | $12.02 | $16.22 | $16.98 |
Sentara Setting Facility Modifier None Typical Low $12.30 Median $16.98 Typical High $53.70 | Facility | None | $12.30 | $16.98 | $53.70 |
Sentara Setting Professional Modifier None Typical Low $13.49 Median $18.62 Typical High $38.02 | Professional | None | $13.49 | $18.62 | $38.02 |
United Setting Facility Modifier None Typical Low $12.88 Median $15.49 Typical High $31.62 | Facility | None | $12.88 | $15.49 | $31.62 |
United Setting Professional Modifier None Typical Low $11.48 Median $12.30 Typical High $18.62 | Professional | None | $11.48 | $12.30 | $18.62 |
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 $6.46 Median $6.46 Typical High $6.61 | Professional | 52 · Reduced service | $6.46 | $6.46 | $6.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.57 Median $2.57 Typical High $2.63 | Professional | 53 · Discontinued | $2.57 | $2.57 | $2.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.95 Median $1.95 Typical High $1.95 | Professional | 55 · Aftercare only | $1.95 | $1.95 | $1.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.29 Median $1.29 Typical High $1.32 | Professional | 56 · Pre-op care only | $1.29 | $1.29 | $1.32 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.86 Median $1.86 Typical High $1.95 | Professional | RR · Rental | $1.86 | $1.86 | $1.95 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $13.49 Median $13.80 Typical High $14.13 | Professional | UE · Used equipment | $13.49 | $13.80 | $14.13 |
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· 27th of 51
$17.78
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.