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 $14.13 Median $14.13 Typical High $14.13 | Facility | None | $14.13 | $14.13 | $14.13 |
Aetna Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | None | $14.13 | $14.13 | $14.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $28.84 | Facility | None | $26.92 | $26.92 | $28.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $21.38 | Professional | None | $19.95 | $19.95 | $21.38 |
CareFirst Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $18.62 | Professional | None | $14.13 | $14.13 | $18.62 |
Cigna Setting Facility Modifier None Typical Low $14.13 Median $18.62 Typical High $18.62 | Facility | None | $14.13 | $18.62 | $18.62 |
Cigna Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $18.62 | Professional | None | $13.49 | $13.49 | $18.62 |
Kaiser Permanente Setting Professional Modifier None Typical Low $19.05 Median $26.92 Typical High $35.48 | Professional | None | $19.05 | $26.92 | $35.48 |
Medcost Setting Professional Modifier None Typical Low $15.85 Median $17.78 Typical High $25.12 | Professional | None | $15.85 | $17.78 | $25.12 |
Medcost Setting Facility Modifier None Typical Low $9.33 Median $14.45 Typical High $17.78 | Facility | None | $9.33 | $14.45 | $17.78 |
Medcost Setting Professional Modifier None Typical Low $14.13 Median $17.78 Typical High $19.05 | Professional | None | $14.13 | $17.78 | $19.05 |
Sentara Setting Facility Modifier None Typical Low $13.18 Median $18.62 Typical High $58.88 | Facility | None | $13.18 | $18.62 | $58.88 |
Sentara Setting Professional Modifier None Typical Low $14.45 Median $19.95 Typical High $40.74 | Professional | None | $14.45 | $19.95 | $40.74 |
United Setting Facility Modifier None Typical Low $14.45 Median $16.60 Typical High $36.31 | Facility | None | $14.45 | $16.60 | $36.31 |
United Setting Professional Modifier None Typical Low $12.30 Median $13.18 Typical High $20.42 | Professional | None | $12.30 | $13.18 | $20.42 |
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 $7.08 Median $7.08 Typical High $7.08 | Professional | 52 · Reduced service | $7.08 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $2.82 Typical High $2.82 | Professional | 53 · Discontinued | $2.82 | $2.82 | $2.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.09 Median $2.09 Typical High $2.14 | Professional | 55 · Aftercare only | $2.09 | $2.09 | $2.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.41 Median $1.41 Typical High $1.41 | Professional | 56 · Pre-op care only | $1.41 | $1.41 | $1.41 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.04 Median $2.04 Typical High $2.14 | Professional | RR · Rental | $2.04 | $2.04 | $2.14 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $14.79 Median $15.14 Typical High $15.85 | Professional | UE · Used equipment | $14.79 | $15.14 | $15.85 |
Where Virginia sits
The same service costs 2.8 times more in Hawaii than in Pennsylvania. 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· 22nd of 51
$19.95
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.