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 $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $45.71 Typical High $45.71 | Professional | None | $42.66 | $45.71 | $45.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $93.33 | Facility | None | $87.10 | $87.10 | $93.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $53.70 | Professional | None | $47.86 | $47.86 | $53.70 |
CareFirst Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $60.26 | Professional | None | $53.70 | $53.70 | $60.26 |
Cigna Setting Facility Modifier None Typical Low $32.36 Median $69.18 Typical High $69.18 | Facility | None | $32.36 | $69.18 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $69.18 | Professional | None | $58.88 | $58.88 | $69.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $61.66 Median $87.10 Typical High $114.82 | Professional | None | $61.66 | $87.10 | $114.82 |
Medcost Setting Professional Modifier None Typical Low $44.67 Median $57.54 Typical High $57.54 | Professional | None | $44.67 | $57.54 | $57.54 |
Medcost Setting Facility Modifier None Typical Low $27.54 Median $46.77 Typical High $57.54 | Facility | None | $27.54 | $46.77 | $57.54 |
Medcost Setting Professional Modifier None Typical Low $46.77 Median $52.48 Typical High $57.54 | Professional | None | $46.77 | $52.48 | $57.54 |
Sentara Setting Facility Modifier None Typical Low $42.66 Median $63.10 Typical High $251.19 | Facility | None | $42.66 | $63.10 | $251.19 |
Sentara Setting Professional Modifier None Typical Low $44.67 Median $66.07 Typical High $131.83 | Professional | None | $44.67 | $66.07 | $131.83 |
United Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $128.82 | Facility | None | $107.15 | $107.15 | $128.82 |
United Setting Professional Modifier None Typical Low $38.90 Median $42.66 Typical High $64.57 | Professional | None | $38.90 | $42.66 | $64.57 |
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 $21.38 Median $22.39 Typical High $22.91 | Professional | 52 · Reduced service | $21.38 | $22.39 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $9.12 Typical High $9.12 | Professional | 53 · Discontinued | $8.51 | $9.12 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.76 Typical High $6.92 | Professional | 55 · Aftercare only | $6.46 | $6.76 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.47 Typical High $4.57 | Professional | 56 · Pre-op care only | $4.27 | $4.47 | $4.57 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.90 Median $4.90 Typical High $6.17 | Professional | RR · Rental | $4.90 | $4.90 | $6.17 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $35.48 Median $36.31 Typical High $38.90 | Professional | UE · Used equipment | $35.48 | $36.31 | $38.90 |
Where Virginia sits
The same service costs 2.0 times more in Montana than in South Carolina. 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· 46th of 51
$48.98
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.