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 $309.03 Median $524.81 Typical High $524.81 | Facility | None | $309.03 | $524.81 | $524.81 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $524.81 Typical High $616.60 | Professional | None | $309.03 | $524.81 | $616.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $776.25 | Facility | None | $741.31 | $741.31 | $776.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $467.74 Median $776.25 Typical High $1,148.15 | Professional | None | $467.74 | $776.25 | $1,148.15 |
CareFirst Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $630.96 Typical High $707.95 | Facility | None | $457.09 | $630.96 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $630.96 | Professional | None | $467.74 | $467.74 | $630.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $467.74 Median $660.69 Typical High $1,096.48 | Professional | None | $467.74 | $660.69 | $1,096.48 |
Medcost Setting Facility Modifier None Typical Low $436.52 Median $588.84 Typical High $707.95 | Facility | None | $436.52 | $588.84 | $707.95 |
Medcost Setting Professional Modifier None Typical Low $588.84 Median $630.96 Typical High $912.01 | Professional | None | $588.84 | $630.96 | $912.01 |
Sentara Setting Facility Modifier None Typical Low $478.63 Median $831.76 Typical High $1,621.81 | Facility | None | $478.63 | $831.76 | $1,621.81 |
Sentara Setting Professional Modifier None Typical Low $512.86 Median $831.76 Typical High $1,230.27 | Professional | None | $512.86 | $831.76 | $1,230.27 |
United Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $1,148.15 | Facility | None | $954.99 | $954.99 | $1,148.15 |
United Setting Professional Modifier None Typical Low $478.63 Median $524.81 Typical High $831.76 | Professional | None | $478.63 | $524.81 | $831.76 |
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 $154.88 Median $263.03 Typical High $263.03 | Professional | 52 · Reduced service | $154.88 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $104.71 Typical High $104.71 | Professional | 53 · Discontinued | $61.66 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $46.77 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $52.48 Typical High $52.48 | Professional | 56 · Pre-op care only | $30.90 | $52.48 | $52.48 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $69.18 Median $69.18 Typical High $74.13 | Professional | RR · Rental | $69.18 | $69.18 | $74.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $436.52 Median $512.86 Typical High $512.86 | Professional | UE · Used equipment | $436.52 | $512.86 | $512.86 |
Where Virginia sits
The same service costs 2.2 times more in Kansas 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· 32nd of 51
$575
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.