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 $223.87 Median $223.87 Typical High $223.87 | Facility | None | $223.87 | $223.87 | $223.87 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $223.87 Typical High $223.87 | Professional | None | $204.17 | $223.87 | $223.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $616.60 | Professional | None | $537.03 | $537.03 | $616.60 |
CareFirst Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $295.12 | Professional | None | $275.42 | $275.42 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $371.54 Typical High $371.54 | Facility | None | $173.78 | $371.54 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $371.54 | Professional | None | $316.23 | $316.23 | $371.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $302.00 Median $426.58 Typical High $562.34 | Professional | None | $302.00 | $426.58 | $562.34 |
Medcost Setting Professional Modifier None Typical Low $251.19 Median $281.84 Typical High $389.05 | Professional | None | $251.19 | $281.84 | $389.05 |
Medcost Setting Facility Modifier None Typical Low $147.91 Median $229.09 Typical High $281.84 | Facility | None | $147.91 | $229.09 | $281.84 |
Medcost Setting Professional Modifier None Typical Low $229.09 Median $245.47 Typical High $281.84 | Professional | None | $229.09 | $245.47 | $281.84 |
Sentara Setting Facility Modifier None Typical Low $208.93 Median $295.12 Typical High $660.69 | Facility | None | $208.93 | $295.12 | $660.69 |
Sentara Setting Professional Modifier None Typical Low $218.78 Median $316.23 Typical High $588.84 | Professional | None | $218.78 | $316.23 | $588.84 |
United Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
United Setting Professional Modifier None Typical Low $194.98 Median $208.93 Typical High $323.59 | Professional | None | $194.98 | $208.93 | $323.59 |
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 $102.33 Median $109.65 Typical High $112.20 | Professional | 52 · Reduced service | $102.33 | $109.65 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $44.67 Typical High $44.67 | Professional | 53 · Discontinued | $40.74 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $33.11 Typical High $33.88 | Professional | 55 · Aftercare only | $30.90 | $33.11 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $22.39 Typical High $22.39 | Professional | 56 · Pre-op care only | $20.42 | $22.39 | $22.39 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $15.14 Median $33.11 Typical High $36.31 | Professional | RR · Rental | $15.14 | $33.11 | $36.31 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $112.20 Median $251.19 Typical High $275.42 | Professional | UE · Used equipment | $112.20 | $251.19 | $275.42 |
Where Virginia sits
The same service costs 3.4 times more in Montana than in New York. 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· 32nd of 51
$316
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.