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 $64.57 Median $64.57 Typical High $66.07 | Facility | None | $64.57 | $64.57 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $64.57 Typical High $66.07 | Professional | None | $61.66 | $64.57 | $66.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $134.90 | Facility | None | $125.89 | $125.89 | $134.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $363.08 | Professional | None | $331.13 | $331.13 | $363.08 |
CareFirst Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $87.10 | Professional | None | $69.18 | $69.18 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $46.77 Median $100.00 Typical High $100.00 | Facility | None | $46.77 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $100.00 | Professional | None | $85.11 | $85.11 | $100.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $89.13 Median $125.89 Typical High $165.96 | Professional | None | $89.13 | $125.89 | $165.96 |
Medcost Setting Professional Modifier None Typical Low $64.57 Median $83.18 Typical High $114.82 | Professional | None | $64.57 | $83.18 | $114.82 |
Medcost Setting Facility Modifier None Typical Low $39.81 Median $67.61 Typical High $83.18 | Facility | None | $39.81 | $67.61 | $83.18 |
Medcost Setting Professional Modifier None Typical Low $67.61 Median $75.86 Typical High $89.13 | Professional | None | $67.61 | $75.86 | $89.13 |
Sentara Setting Facility Modifier None Typical Low $61.66 Median $89.13 Typical High $363.08 | Facility | None | $61.66 | $89.13 | $363.08 |
Sentara Setting Professional Modifier None Typical Low $67.61 Median $93.33 Typical High $190.55 | Professional | None | $67.61 | $93.33 | $190.55 |
United Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $186.21 | Facility | None | $154.88 | $154.88 | $186.21 |
United Setting Professional Modifier None Typical Low $56.23 Median $61.66 Typical High $93.33 | Professional | None | $56.23 | $61.66 | $93.33 |
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 $30.90 Median $32.36 Typical High $33.11 | Professional | 52 · Reduced service | $30.90 | $32.36 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $13.18 Typical High $13.18 | Professional | 53 · Discontinued | $12.30 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $9.77 Typical High $10.00 | Professional | 55 · Aftercare only | $9.33 | $9.77 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.46 Typical High $6.61 | Professional | 56 · Pre-op care only | $6.17 | $6.46 | $6.61 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $33.11 Median $33.11 Typical High $36.31 | Professional | RR · Rental | $33.11 | $33.11 | $36.31 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $213.80 Median $251.19 Typical High $251.19 | Professional | UE · Used equipment | $213.80 | $251.19 | $251.19 |
Where Virginia sits
The same service costs 2.4 times more in Indiana than in Kentucky. 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· 19th of 51
$100
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.