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 $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $42.66 Typical High $42.66 | Professional | None | $40.74 | $42.66 | $42.66 |
Anthem BCBS Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $87.10 | Facility | None | $81.28 | $81.28 | $87.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $58.88 | Professional | None | $52.48 | $52.48 | $58.88 |
CareFirst Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $56.23 | Professional | None | $42.66 | $42.66 | $56.23 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $51.29 Typical High $51.29 | Facility | None | $34.67 | $51.29 | $51.29 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $51.29 | Professional | None | $38.02 | $38.02 | $51.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $57.54 Median $81.28 Typical High $107.15 | Professional | None | $57.54 | $81.28 | $107.15 |
Medcost Setting Professional Modifier None Typical Low $47.86 Median $53.70 Typical High $74.13 | Professional | None | $47.86 | $53.70 | $74.13 |
Medcost Setting Facility Modifier None Typical Low $28.18 Median $43.65 Typical High $53.70 | Facility | None | $28.18 | $43.65 | $53.70 |
Medcost Setting Professional Modifier None Typical Low $35.48 Median $47.86 Typical High $53.70 | Professional | None | $35.48 | $47.86 | $53.70 |
Sentara Setting Facility Modifier None Typical Low $39.81 Median $56.23 Typical High $173.78 | Facility | None | $39.81 | $56.23 | $173.78 |
Sentara Setting Professional Modifier None Typical Low $43.65 Median $60.26 Typical High $123.03 | Professional | None | $43.65 | $60.26 | $123.03 |
United Setting Facility Modifier None Typical Low $53.70 Median $64.57 Typical High $109.65 | Facility | None | $53.70 | $64.57 | $109.65 |
United Setting Professional Modifier None Typical Low $37.15 Median $39.81 Typical High $61.66 | Professional | None | $37.15 | $39.81 | $61.66 |
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 $20.89 Median $20.89 Typical High $21.38 | Professional | 52 · Reduced service | $20.89 | $20.89 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $8.51 Typical High $8.51 | Professional | 53 · Discontinued | $8.32 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.31 Typical High $6.46 | Professional | 55 · Aftercare only | $6.31 | $6.31 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.27 Typical High $4.27 | Professional | 56 · Pre-op care only | $4.17 | $4.27 | $4.27 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.37 Median $5.37 Typical High $6.17 | Professional | RR · Rental | $5.37 | $5.37 | $6.17 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $38.90 Median $40.74 Typical High $42.66 | Professional | UE · Used equipment | $38.90 | $40.74 | $42.66 |
Where Virginia sits
The same service costs 4.9 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· 33rd of 51
$52.48
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.