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 $16.22 Median $16.22 Typical High $16.60 | Facility | None | $16.22 | $16.22 | $16.60 |
Aetna Setting Professional Modifier None Typical Low $15.49 Median $16.22 Typical High $16.60 | Professional | None | $15.49 | $16.22 | $16.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $31.62 Median $31.62 Typical High $33.11 | Facility | None | $31.62 | $31.62 | $33.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $26.92 | Professional | None | $25.12 | $25.12 | $26.92 |
CareFirst Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $21.38 | Professional | None | $17.38 | $17.38 | $21.38 |
Cigna Setting Facility Modifier None Typical Low $11.75 Median $25.12 Typical High $25.12 | Facility | None | $11.75 | $25.12 | $25.12 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $25.12 | Professional | None | $21.38 | $21.38 | $25.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $21.88 Median $31.62 Typical High $40.74 | Professional | None | $21.88 | $31.62 | $40.74 |
Medcost Setting Professional Modifier None Typical Low $15.85 Median $20.42 Typical High $28.84 | Professional | None | $15.85 | $20.42 | $28.84 |
Medcost Setting Facility Modifier None Typical Low $10.00 Median $16.98 Typical High $20.42 | Facility | None | $10.00 | $16.98 | $20.42 |
Medcost Setting Professional Modifier None Typical Low $16.98 Median $19.05 Typical High $22.39 | Professional | None | $16.98 | $19.05 | $22.39 |
Sentara Setting Facility Modifier None Typical Low $15.14 Median $23.44 Typical High $91.20 | Facility | None | $15.14 | $23.44 | $91.20 |
Sentara Setting Professional Modifier None Typical Low $16.22 Median $23.99 Typical High $51.29 | Professional | None | $16.22 | $23.99 | $51.29 |
United Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $45.71 | Facility | None | $38.90 | $38.90 | $45.71 |
United Setting Professional Modifier None Typical Low $14.13 Median $15.49 Typical High $23.44 | Professional | None | $14.13 | $15.49 | $23.44 |
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 $7.76 Median $8.13 Typical High $8.32 | Professional | 52 · Reduced service | $7.76 | $8.13 | $8.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.09 Median $3.24 Typical High $3.31 | Professional | 53 · Discontinued | $3.09 | $3.24 | $3.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.29 Median $2.45 Typical High $2.45 | Professional | 55 · Aftercare only | $2.29 | $2.45 | $2.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.55 Median $1.62 Typical High $1.66 | Professional | 56 · Pre-op care only | $1.55 | $1.62 | $1.66 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.51 Median $2.57 Typical High $2.69 | Professional | RR · Rental | $2.51 | $2.57 | $2.69 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $18.62 Median $19.05 Typical High $19.05 | Professional | UE · Used equipment | $18.62 | $19.05 | $19.05 |
Where Virginia sits
The same service costs 2.1 times more in Minnesota 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· 16th of 51
$25.12
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.