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 $398.11 Median $398.11 Typical High $831.76 | Facility | None | $398.11 | $398.11 | $831.76 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $562.34 | Professional | None | $457.09 | $457.09 | $562.34 |
CareFirst Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $524.81 | Professional | None | $416.87 | $416.87 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $660.69 Typical High $660.69 | Facility | None | $309.03 | $660.69 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $660.69 | Professional | None | $562.34 | $562.34 | $660.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $537.03 Median $758.58 Typical High $1,000.00 | Professional | None | $537.03 | $758.58 | $1,000.00 |
Medcost Setting Professional Modifier None Typical Low $446.68 Median $501.19 Typical High $707.95 | Professional | None | $446.68 | $501.19 | $707.95 |
Medcost Setting Facility Modifier None Typical Low $263.03 Median $407.38 Typical High $501.19 | Facility | None | $263.03 | $407.38 | $501.19 |
Medcost Setting Professional Modifier None Typical Low $407.38 Median $416.87 Typical High $501.19 | Professional | None | $407.38 | $416.87 | $501.19 |
Sentara Setting Facility Modifier None Typical Low $371.54 Median $524.81 Typical High $1,202.26 | Facility | None | $371.54 | $524.81 | $1,202.26 |
Sentara Setting Professional Modifier None Typical Low $398.11 Median $562.34 Typical High $1,047.13 | Professional | None | $398.11 | $562.34 | $1,047.13 |
United Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
United Setting Professional Modifier None Typical Low $346.74 Median $371.54 Typical High $575.44 | Professional | None | $346.74 | $371.54 | $575.44 |
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 $199.53 Median $199.53 Typical High $199.53 | Professional | 52 · Reduced service | $199.53 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $79.43 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $58.88 Typical High $60.26 | Professional | 55 · Aftercare only | $58.88 | $58.88 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | 56 · Pre-op care only | $39.81 | $39.81 | $39.81 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $45.71 Median $45.71 Typical High $58.88 | Professional | RR · Rental | $45.71 | $45.71 | $58.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $338.84 Median $338.84 Typical High $371.54 | Professional | UE · Used equipment | $338.84 | $338.84 | $371.54 |
Where Virginia sits
The same service costs 2.5 times more in Montana than in Washington, DC. 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· 49th of 51
$457
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.