How much rates vary
Facilitymedian $234 · 10th to 90th $170 to $407Professionalmedian $200 · 10th to 90th $158 to $263
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 $104.71 Median $169.82 Typical High $169.82 | Facility | None | $104.71 | $169.82 | $169.82 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $169.82 Typical High $169.82 | Professional | None | $104.71 | $169.82 | $169.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $269.15 | Facility | None | $251.19 | $251.19 | $269.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $213.80 | Professional | None | $199.53 | $199.53 | $213.80 |
CareFirst Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $213.80 Typical High $213.80 | Facility | None | $147.91 | $213.80 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $213.80 | Professional | None | $158.49 | $158.49 | $213.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $158.49 Median $229.09 Typical High $380.19 | Professional | None | $158.49 | $229.09 | $380.19 |
Medcost Setting Professional Modifier None Typical Low $204.17 Median $229.09 Typical High $323.59 | Professional | None | $204.17 | $229.09 | $323.59 |
Medcost Setting Facility Modifier None Typical Low $109.65 Median $186.21 Typical High $229.09 | Facility | None | $109.65 | $186.21 | $229.09 |
Medcost Setting Professional Modifier None Typical Low $158.49 Median $186.21 Typical High $316.23 | Professional | None | $158.49 | $186.21 | $316.23 |
Sentara Setting Facility Modifier None Typical Low $165.96 Median $229.09 Typical High $758.58 | Facility | None | $165.96 | $229.09 | $758.58 |
Sentara Setting Professional Modifier None Typical Low $169.82 Median $239.88 Typical High $478.63 | Professional | None | $169.82 | $239.88 | $478.63 |
United Setting Facility Modifier None Typical Low $213.80 Median $234.42 Typical High $407.38 | Facility | None | $213.80 | $234.42 | $407.38 |
United Setting Professional Modifier None Typical Low $154.88 Median $169.82 Typical High $257.04 | Professional | None | $154.88 | $169.82 | $257.04 |
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 $52.48 Median $85.11 Typical High $85.11 | Professional | 52 · Reduced service | $52.48 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $33.88 Typical High $33.88 | Professional | 53 · Discontinued | $20.89 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $25.12 Typical High $25.12 | Professional | 55 · Aftercare only | $15.85 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $16.98 Typical High $16.98 | Professional | 56 · Pre-op care only | $10.47 | $16.98 | $16.98 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $19.95 Median $20.42 Typical High $21.38 | Professional | RR · Rental | $19.95 | $20.42 | $21.38 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $147.91 Median $151.36 Typical High $151.36 | Professional | UE · Used equipment | $147.91 | $151.36 | $151.36 |
Where Virginia sits
The same service costs 2.9 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· 28th of 51
$200
HI $437UT $151
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.