How much rates vary
Facilitymedian $513 · 10th to 90th $324 to $1,023Professionalmedian $398 · 10th to 90th $309 to $550
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 $269.15 Median $323.59 Typical High $323.59 | Facility | None | $269.15 | $323.59 | $323.59 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $323.59 Typical High $338.84 | Professional | None | $269.15 | $323.59 | $338.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $724.44 | Facility | None | $676.08 | $676.08 | $724.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $446.68 | Professional | None | $398.11 | $398.11 | $446.68 |
CareFirst Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $467.74 | Professional | None | $398.11 | $398.11 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $416.87 Typical High $416.87 | Facility | None | $295.12 | $416.87 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $416.87 | Professional | None | $309.03 | $309.03 | $416.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $467.74 Median $676.08 Typical High $870.96 | Professional | None | $467.74 | $676.08 | $870.96 |
Medcost Setting Professional Modifier None Typical Low $398.11 Median $446.68 Typical High $588.84 | Professional | None | $398.11 | $446.68 | $588.84 |
Medcost Setting Facility Modifier None Typical Low $213.80 Median $363.08 Typical High $436.52 | Facility | None | $213.80 | $363.08 | $436.52 |
Medcost Setting Professional Modifier None Typical Low $363.08 Median $407.38 Typical High $851.14 | Professional | None | $363.08 | $407.38 | $851.14 |
Sentara Setting Facility Modifier None Typical Low $331.13 Median $489.78 Typical High $1,949.84 | Facility | None | $331.13 | $489.78 | $1,949.84 |
Sentara Setting Professional Modifier None Typical Low $346.74 Median $512.86 Typical High $1,023.29 | Professional | None | $346.74 | $512.86 | $1,023.29 |
United Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $977.24 | Facility | None | $831.76 | $831.76 | $977.24 |
United Setting Professional Modifier None Typical Low $295.12 Median $331.13 Typical High $501.19 | Professional | None | $295.12 | $331.13 | $501.19 |
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 $134.90 Median $162.18 Typical High $162.18 | Professional | 52 · Reduced service | $134.90 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $66.07 Typical High $66.07 | Professional | 53 · Discontinued | $53.70 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $48.98 Typical High $48.98 | Professional | 55 · Aftercare only | $40.74 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $32.36 Typical High $32.36 | Professional | 56 · Pre-op care only | $26.92 | $32.36 | $32.36 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $40.74 Median $40.74 Typical High $47.86 | Professional | RR · Rental | $40.74 | $40.74 | $47.86 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $295.12 Median $309.03 Typical High $323.59 | Professional | UE · Used equipment | $295.12 | $309.03 | $323.59 |
Where Virginia sits
The same service costs 2.2 times more in Montana than in Delaware. 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· 30th of 51
$398
MT $692DE $309
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.