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 $354.81 Median $354.81 Typical High $354.81 | Facility | None | $354.81 | $354.81 | $354.81 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $354.81 Typical High $354.81 | Professional | None | $331.13 | $354.81 | $354.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $870.96 | Professional | None | $758.58 | $758.58 | $870.96 |
CareFirst Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $467.74 | Professional | None | $446.68 | $446.68 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $371.54 Typical High $371.54 | Facility | None | $251.19 | $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 $478.63 Median $676.08 Typical High $891.25 | Professional | None | $478.63 | $676.08 | $891.25 |
Medcost Setting Professional Modifier None Typical Low $398.11 Median $446.68 Typical High $630.96 | Professional | None | $398.11 | $446.68 | $630.96 |
Medcost Setting Facility Modifier None Typical Low $213.80 Median $363.08 Typical High $446.68 | Facility | None | $213.80 | $363.08 | $446.68 |
Medcost Setting Professional Modifier None Typical Low $363.08 Median $371.54 Typical High $446.68 | Professional | None | $363.08 | $371.54 | $446.68 |
Sentara Setting Facility Modifier None Typical Low $331.13 Median $467.74 Typical High $1,071.52 | Facility | None | $331.13 | $467.74 | $1,071.52 |
Sentara Setting Professional Modifier None Typical Low $363.08 Median $501.19 Typical High $933.25 | Professional | None | $363.08 | $501.19 | $933.25 |
United Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
United Setting Professional Modifier None Typical Low $302.00 Median $331.13 Typical High $501.19 | Professional | None | $302.00 | $331.13 | $501.19 |
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 $162.18 Median $177.83 Typical High $177.83 | Professional | 52 · Reduced service | $162.18 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $70.79 Typical High $70.79 | Professional | 53 · Discontinued | $66.07 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $52.48 Typical High $53.70 | Professional | 55 · Aftercare only | $48.98 | $52.48 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $35.48 Typical High $35.48 | Professional | 56 · Pre-op care only | $33.11 | $35.48 | $35.48 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $21.38 Median $47.86 Typical High $54.95 | Professional | RR · Rental | $21.38 | $47.86 | $54.95 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $162.18 Median $354.81 Typical High $416.87 | Professional | UE · Used equipment | $162.18 | $354.81 | $416.87 |
Where Virginia sits
The same service costs 2.6 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· 19th of 51
$447
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.