How much rates vary
Facilitymedian $166 · 10th to 90th $17 to $316Professionalmedian $195 · 10th to 90th $32 to $245
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 $112.20 Median $154.88 Typical High $154.88 | Facility | None | $112.20 | $154.88 | $154.88 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $154.88 Typical High $154.88 | Professional | None | $112.20 | $154.88 | $154.88 |
Aetna Setting Professional Modifier UE · Used equipment Typical Low $83.18 Median $114.82 Typical High $114.82 | Professional | UE · Used equipment | $83.18 | $114.82 | $114.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $16.60 Median $19.50 Typical High $20.89 | Professional | RR · Rental | $16.60 | $19.50 | $20.89 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $138.04 Median $144.54 Typical High $144.54 | Professional | UE · Used equipment | $138.04 | $144.54 | $144.54 |
CareFirst Setting Professional Modifier None Typical Low $19.95 Median $199.53 Typical High $199.53 | Professional | None | $19.95 | $199.53 | $199.53 |
CareFirst Setting Professional Modifier RR · Rental Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | RR · Rental | $19.95 | $19.95 | $19.95 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Facility | None | $177.83 | $177.83 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $177.83 | Professional | None | $151.36 | $151.36 | $177.83 |
Cigna Setting Professional Modifier RR · Rental Typical Low $15.14 Median $15.14 Typical High $17.78 | Professional | RR · Rental | $15.14 | $15.14 | $17.78 |
Cigna Setting Professional Modifier UE · Used equipment Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | UE · Used equipment | $114.82 | $114.82 | $114.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $208.93 Median $251.19 Typical High $338.84 | Professional | None | $208.93 | $251.19 | $338.84 |
Medcost Setting Professional Modifier RR · Rental Typical Low $20.89 Median $20.89 Typical High $41.69 | Professional | RR · Rental | $20.89 | $20.89 | $41.69 |
Medcost Setting Facility Modifier None Typical Low $138.04 Median $169.82 Typical High $204.17 | Facility | None | $138.04 | $169.82 | $204.17 |
Medcost Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
Sentara Setting Facility Modifier None Typical Low $16.60 Median $120.23 Typical High $389.05 | Facility | None | $16.60 | $120.23 | $389.05 |
Sentara Setting Professional Modifier None Typical Low $16.60 Median $120.23 Typical High $389.05 | Professional | None | $16.60 | $120.23 | $389.05 |
Sentara Setting Professional Modifier RR · Rental Typical Low $14.45 Median $32.36 Typical High $38.90 | Professional | RR · Rental | $14.45 | $32.36 | $38.90 |
United Setting Professional Modifier None Typical Low $109.65 Median $134.90 Typical High $269.15 | Professional | None | $109.65 | $134.90 | $269.15 |
United Setting Professional Modifier RR · Rental Typical Low $13.80 Median $15.85 Typical High $26.30 | Professional | RR · Rental | $13.80 | $15.85 | $26.30 |
United Setting Professional Modifier UE · Used equipment Typical Low $81.28 Median $100.00 Typical High $199.53 | Professional | UE · Used equipment | $81.28 | $100.00 | $199.53 |
4 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 $56.23 Median $77.62 Typical High $77.62 | Professional | 52 · Reduced service | $56.23 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $30.90 Typical High $30.90 | Professional | 53 · Discontinued | $22.91 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $22.91 Typical High $22.91 | Professional | 55 · Aftercare only | $16.98 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $15.49 Typical High $15.49 | Professional | 56 · Pre-op care only | $11.22 | $15.49 | $15.49 |
Where Virginia sits
The same service costs 22.4 times more in Kansas than in Illinois. 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· 23rd of 51
$186
KS $447IL $19.95
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.