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 $38.90 Median $38.90 Typical High $39.81 | Facility | None | $38.90 | $38.90 | $39.81 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $38.90 Typical High $39.81 | Professional | None | $37.15 | $38.90 | $39.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $81.28 | Facility | None | $75.86 | $75.86 | $81.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $52.48 | Professional | None | $42.66 | $42.66 | $52.48 |
CareFirst Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $52.48 | Professional | None | $43.65 | $43.65 | $52.48 |
Cigna Setting Facility Modifier None Typical Low $28.18 Median $43.65 Typical High $43.65 | Facility | None | $28.18 | $43.65 | $43.65 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $43.65 | Professional | None | $37.15 | $37.15 | $43.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $53.70 Median $75.86 Typical High $97.72 | Professional | None | $53.70 | $75.86 | $97.72 |
Medcost Setting Professional Modifier None Typical Low $38.02 Median $50.12 Typical High $69.18 | Professional | None | $38.02 | $50.12 | $69.18 |
Medcost Setting Facility Modifier None Typical Low $23.99 Median $40.74 Typical High $48.98 | Facility | None | $23.99 | $40.74 | $48.98 |
Medcost Setting Professional Modifier None Typical Low $40.74 Median $45.71 Typical High $53.70 | Professional | None | $40.74 | $45.71 | $53.70 |
Sentara Setting Facility Modifier None Typical Low $37.15 Median $56.23 Typical High $218.78 | Facility | None | $37.15 | $56.23 | $218.78 |
Sentara Setting Professional Modifier None Typical Low $38.90 Median $57.54 Typical High $117.49 | Professional | None | $38.90 | $57.54 | $117.49 |
United Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $112.20 | Facility | None | $93.33 | $93.33 | $112.20 |
United Setting Professional Modifier None Typical Low $33.88 Median $37.15 Typical High $56.23 | Professional | None | $33.88 | $37.15 | $56.23 |
4 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 55 · Aftercare only Typical Low $5.62 Median $5.89 Typical High $5.89 | Professional | 55 · Aftercare only | $5.62 | $5.89 | $5.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $3.89 Typical High $3.98 | Professional | 56 · Pre-op care only | $3.72 | $3.89 | $3.98 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.27 Median $4.27 Typical High $5.37 | Professional | RR · Rental | $4.27 | $4.27 | $5.37 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $31.62 Median $31.62 Typical High $34.67 | Professional | UE · Used equipment | $31.62 | $31.62 | $34.67 |
Where Virginia sits
The same service costs 2.2 times more in Montana than in West 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· 36th of 51
$42.66
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.