How much rates vary
Facilitymedian $316 · 10th to 90th $240 to $501Professionalmedian $282 · 10th to 90th $219 to $380
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 $134.90 Median $239.88 Typical High $239.88 | Facility | None | $134.90 | $239.88 | $239.88 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $239.88 Typical High $263.03 | Professional | None | $134.90 | $239.88 | $263.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $338.84 | Facility | None | $316.23 | $316.23 | $338.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $309.03 | Professional | None | $281.84 | $281.84 | $309.03 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $28.18 Median $28.18 Typical High $30.90 | Professional | RR · Rental | $28.18 | $28.18 | $30.90 |
CareFirst Setting Professional Modifier None Typical Low $263.03 Median $302.00 Typical High $302.00 | Professional | None | $263.03 | $302.00 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $302.00 Typical High $302.00 | Facility | None | $194.98 | $302.00 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $302.00 | Professional | None | $218.78 | $218.78 | $302.00 |
Cigna Setting Professional Modifier RR · Rental Typical Low $25.70 Median $25.70 Typical High $30.20 | Professional | RR · Rental | $25.70 | $25.70 | $30.20 |
Kaiser Permanente Setting Professional Modifier None Typical Low $194.98 Median $281.84 Typical High $489.78 | Professional | None | $194.98 | $281.84 | $489.78 |
Medcost Setting Facility Modifier None Typical Low $109.65 Median $263.03 Typical High $323.59 | Facility | None | $109.65 | $263.03 | $323.59 |
Medcost Setting Professional Modifier None Typical Low $263.03 Median $302.00 Typical High $398.11 | Professional | None | $263.03 | $302.00 | $398.11 |
Sentara Setting Facility Modifier None Typical Low $208.93 Median $380.19 Typical High $741.31 | Facility | None | $208.93 | $380.19 | $741.31 |
Sentara Setting Professional Modifier None Typical Low $229.09 Median $380.19 Typical High $549.54 | Professional | None | $229.09 | $380.19 | $549.54 |
United Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $588.84 | Facility | None | $489.78 | $489.78 | $588.84 |
United Setting Professional Modifier None Typical Low $218.78 Median $239.88 Typical High $380.19 | Professional | None | $218.78 | $239.88 | $380.19 |
5 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 $67.61 Median $120.23 Typical High $120.23 | Professional | 52 · Reduced service | $67.61 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $47.86 Typical High $47.86 | Professional | 53 · Discontinued | $26.92 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $35.48 Typical High $35.48 | Professional | 55 · Aftercare only | $20.42 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $23.99 Typical High $23.99 | Professional | 56 · Pre-op care only | $13.49 | $23.99 | $23.99 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $181.97 Median $213.80 Typical High $213.80 | Professional | UE · Used equipment | $181.97 | $213.80 | $213.80 |
Where Virginia sits
The same service costs 2.6 times more in Hawaii than in Utah. 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· 20th of 51
$282
HI $490UT $191
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.