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 $338.84 Median $602.56 Typical High $602.56 | Facility | None | $338.84 | $602.56 | $602.56 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $602.56 Typical High $602.56 | Professional | None | $338.84 | $602.56 | $602.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $794.33 Median $794.33 Typical High $851.14 | Facility | None | $794.33 | $794.33 | $851.14 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $758.58 | Professional | None | $707.95 | $707.95 | $758.58 |
CareFirst Setting Professional Modifier None Typical Low $660.69 Median $758.58 Typical High $758.58 | Professional | None | $660.69 | $758.58 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $758.58 Typical High $758.58 | Facility | None | $489.78 | $758.58 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $758.58 | Professional | None | $549.54 | $549.54 | $758.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $489.78 Median $691.83 Typical High $1,230.27 | Professional | None | $489.78 | $691.83 | $1,230.27 |
Medcost Setting Facility Modifier None Typical Low $275.42 Median $660.69 Typical High $794.33 | Facility | None | $275.42 | $660.69 | $794.33 |
Medcost Setting Professional Modifier None Typical Low $660.69 Median $741.31 Typical High $1,000.00 | Professional | None | $660.69 | $741.31 | $1,000.00 |
Sentara Setting Facility Modifier None Typical Low $524.81 Median $954.99 Typical High $1,862.09 | Facility | None | $524.81 | $954.99 | $1,862.09 |
Sentara Setting Professional Modifier None Typical Low $575.44 Median $954.99 Typical High $1,380.38 | Professional | None | $575.44 | $954.99 | $1,380.38 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,479.11 | Facility | None | $1,230.27 | $1,230.27 | $1,479.11 |
United Setting Professional Modifier None Typical Low $549.54 Median $602.56 Typical High $954.99 | Professional | None | $549.54 | $602.56 | $954.99 |
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 $169.82 Median $295.12 Typical High $295.12 | Professional | 52 · Reduced service | $169.82 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $120.23 Typical High $120.23 | Professional | 53 · Discontinued | $67.61 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $89.13 Typical High $89.13 | Professional | 55 · Aftercare only | $50.12 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $60.26 Typical High $60.26 | Professional | 56 · Pre-op care only | $33.88 | $60.26 | $60.26 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $70.79 Median $70.79 Typical High $75.86 | Professional | RR · Rental | $70.79 | $70.79 | $75.86 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $446.68 Median $537.03 Typical High $537.03 | Professional | UE · Used equipment | $446.68 | $537.03 | $537.03 |
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· 18th of 51
$708
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.