How much rates vary
Facilitymedian $316 · 10th to 90th $234 to $589Professionalmedian $257 · 10th to 90th $204 to $417
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 $173.78 Median $263.03 Typical High $575.44 | Facility | None | $173.78 | $263.03 | $575.44 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $213.80 Typical High $512.86 | Professional | None | $173.78 | $213.80 | $512.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $467.74 | Facility | None | $436.52 | $436.52 | $467.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $354.81 | Professional | None | $263.03 | $263.03 | $354.81 |
CareFirst Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $302.00 | Professional | None | $229.09 | $229.09 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $346.74 | Facility | None | $316.23 | $316.23 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $316.23 | Professional | None | $229.09 | $229.09 | $316.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $309.03 Median $436.52 Typical High $575.44 | Professional | None | $309.03 | $436.52 | $575.44 |
Medcost Setting Professional Modifier None Typical Low $257.04 Median $288.40 Typical High $398.11 | Professional | None | $257.04 | $288.40 | $398.11 |
Medcost Setting Facility Modifier None Typical Low $147.91 Median $234.42 Typical High $288.40 | Facility | None | $147.91 | $234.42 | $288.40 |
Medcost Setting Professional Modifier None Typical Low $204.17 Median $234.42 Typical High $549.54 | Professional | None | $204.17 | $234.42 | $549.54 |
Sentara Setting Facility Modifier None Typical Low $213.80 Median $302.00 Typical High $933.25 | Facility | None | $213.80 | $302.00 | $933.25 |
Sentara Setting Professional Modifier None Typical Low $234.42 Median $323.59 Typical High $660.69 | Professional | None | $234.42 | $323.59 | $660.69 |
United Setting Facility Modifier None Typical Low $245.47 Median $269.15 Typical High $562.34 | Facility | None | $245.47 | $269.15 | $562.34 |
United Setting Professional Modifier None Typical Low $194.98 Median $213.80 Typical High $323.59 | Professional | None | $194.98 | $213.80 | $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 $87.10 Median $107.15 Typical High $107.15 | Professional | 52 · Reduced service | $87.10 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $42.66 Typical High $42.66 | Professional | 53 · Discontinued | $35.48 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $31.62 Typical High $31.62 | Professional | 55 · Aftercare only | $26.30 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $21.38 Typical High $21.38 | Professional | 56 · Pre-op care only | $17.38 | $21.38 | $21.38 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $26.30 Median $26.30 Typical High $33.88 | Professional | RR · Rental | $26.30 | $26.30 | $33.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $190.55 Median $194.98 Typical High $194.98 | Professional | UE · Used equipment | $190.55 | $194.98 | $194.98 |
Where Virginia sits
The same service costs 2.6 times more in Hawaii than in Arizona. 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· 33rd of 51
$263
HI $589AZ $229
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.