How much rates vary
Facilitymedian $575 · 10th to 90th $398 to $1,175Professionalmedian $355 · 10th to 90th $331 to $646
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 $323.59 Median $489.78 Typical High $1,071.52 | Facility | None | $323.59 | $489.78 | $1,071.52 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $398.11 Typical High $501.19 | Professional | None | $323.59 | $398.11 | $501.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $870.96 | Facility | None | $812.83 | $812.83 | $870.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $371.54 | Professional | None | $331.13 | $331.13 | $371.54 |
CareFirst Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $562.34 | Professional | None | $426.58 | $426.58 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $457.09 Typical High $457.09 | Facility | None | $338.84 | $457.09 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $457.09 | Professional | None | $338.84 | $338.84 | $457.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $575.44 Median $812.83 Typical High $1,047.13 | Professional | None | $575.44 | $812.83 | $1,047.13 |
Medcost Setting Professional Modifier None Typical Low $478.63 Median $537.03 Typical High $741.31 | Professional | None | $478.63 | $537.03 | $741.31 |
Medcost Setting Facility Modifier None Typical Low $239.88 Median $436.52 Typical High $524.81 | Facility | None | $239.88 | $436.52 | $524.81 |
Medcost Setting Professional Modifier None Typical Low $407.38 Median $436.52 Typical High $1,023.29 | Professional | None | $407.38 | $436.52 | $1,023.29 |
Sentara Setting Facility Modifier None Typical Low $398.11 Median $562.34 Typical High $1,737.80 | Facility | None | $398.11 | $562.34 | $1,737.80 |
Sentara Setting Professional Modifier None Typical Low $436.52 Median $602.56 Typical High $1,230.27 | Professional | None | $436.52 | $602.56 | $1,230.27 |
United Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $1,122.02 | Facility | None | $407.38 | $407.38 | $1,122.02 |
United Setting Professional Modifier None Typical Low $338.84 Median $398.11 Typical High $602.56 | Professional | None | $338.84 | $398.11 | $602.56 |
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 $194.98 Typical High $199.53 | Professional | 52 · Reduced service | $162.18 | $194.98 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $79.43 Typical High $81.28 | Professional | 53 · Discontinued | $64.57 | $79.43 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $58.88 Typical High $60.26 | Professional | 55 · Aftercare only | $48.98 | $58.88 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $39.81 Typical High $40.74 | Professional | 56 · Pre-op care only | $32.36 | $39.81 | $40.74 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $33.88 Median $33.88 Typical High $56.23 | Professional | RR · Rental | $33.88 | $33.88 | $56.23 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $213.80 Median $257.04 Typical High $257.04 | Professional | UE · Used equipment | $213.80 | $257.04 | $257.04 |
Where Virginia sits
The same service costs 2.6 times more in Hawaii than in New Hampshire. 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· 44th of 51
$398
HI $871NH $339
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.