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 $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $58.88 Typical High $58.88 | Professional | None | $54.95 | $58.88 | $58.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $120.23 | Facility | None | $112.20 | $112.20 | $120.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $75.86 | Professional | None | $61.66 | $61.66 | $75.86 |
CareFirst Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $77.62 | Professional | None | $64.57 | $64.57 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $42.66 Median $91.20 Typical High $91.20 | Facility | None | $42.66 | $91.20 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $91.20 | Professional | None | $77.62 | $77.62 | $91.20 |
Kaiser Permanente Setting Professional Modifier None Typical Low $79.43 Median $112.20 Typical High $147.91 | Professional | None | $79.43 | $112.20 | $147.91 |
Medcost Setting Professional Modifier None Typical Low $57.54 Median $74.13 Typical High $74.13 | Professional | None | $57.54 | $74.13 | $74.13 |
Medcost Setting Facility Modifier None Typical Low $36.31 Median $60.26 Typical High $74.13 | Facility | None | $36.31 | $60.26 | $74.13 |
Medcost Setting Professional Modifier None Typical Low $60.26 Median $69.18 Typical High $74.13 | Professional | None | $60.26 | $69.18 | $74.13 |
Sentara Setting Facility Modifier None Typical Low $54.95 Median $83.18 Typical High $331.13 | Facility | None | $54.95 | $83.18 | $331.13 |
Sentara Setting Professional Modifier None Typical Low $57.54 Median $87.10 Typical High $173.78 | Professional | None | $57.54 | $87.10 | $173.78 |
United Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $165.96 | Facility | None | $138.04 | $138.04 | $165.96 |
United Setting Professional Modifier None Typical Low $51.29 Median $54.95 Typical High $83.18 | Professional | None | $51.29 | $54.95 | $83.18 |
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 $27.54 Median $29.51 Typical High $29.51 | Professional | 52 · Reduced service | $27.54 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.75 Typical High $11.75 | Professional | 53 · Discontinued | $11.22 | $11.75 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.71 Typical High $8.91 | Professional | 55 · Aftercare only | $8.32 | $8.71 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.89 Typical High $5.89 | Professional | 56 · Pre-op care only | $5.62 | $5.89 | $5.89 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.17 Median $6.17 Typical High $8.13 | Professional | RR · Rental | $6.17 | $6.17 | $8.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $45.71 Median $45.71 Typical High $48.98 | Professional | UE · Used equipment | $45.71 | $45.71 | $48.98 |
Where Virginia sits
The same service costs 1.9 times more in Montana than in Virginia. 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· 51st of 51
$61.66
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.