How much rates vary
Facilitymedian $275 · 10th to 90th $195 to $603Professionalmedian $240 · 10th to 90th $178 to $331
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 $162.18 Median $194.98 Typical High $194.98 | Facility | None | $162.18 | $194.98 | $194.98 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $194.98 Typical High $194.98 | Professional | None | $162.18 | $194.98 | $194.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $426.58 | Facility | None | $398.11 | $398.11 | $426.58 |
Anthem BCBS Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $269.15 | Professional | None | $239.88 | $239.88 | $269.15 |
CareFirst Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $275.42 | Professional | None | $208.93 | $208.93 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $245.47 Typical High $245.47 | Facility | None | $213.80 | $245.47 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $245.47 | Professional | None | $177.83 | $177.83 | $245.47 |
Kaiser Permanente Setting Professional Modifier None Typical Low $281.84 Median $398.11 Typical High $524.81 | Professional | None | $281.84 | $398.11 | $524.81 |
Medcost Setting Professional Modifier None Typical Low $234.42 Median $263.03 Typical High $371.54 | Professional | None | $234.42 | $263.03 | $371.54 |
Medcost Setting Facility Modifier None Typical Low $138.04 Median $213.80 Typical High $263.03 | Facility | None | $138.04 | $213.80 | $263.03 |
Medcost Setting Professional Modifier None Typical Low $186.21 Median $218.78 Typical High $501.19 | Professional | None | $186.21 | $218.78 | $501.19 |
Sentara Setting Facility Modifier None Typical Low $194.98 Median $275.42 Typical High $870.96 | Facility | None | $194.98 | $275.42 | $870.96 |
Sentara Setting Professional Modifier None Typical Low $213.80 Median $295.12 Typical High $602.56 | Professional | None | $213.80 | $295.12 | $602.56 |
United Setting Facility Modifier None Typical Low $147.91 Median $204.17 Typical High $537.03 | Facility | None | $147.91 | $204.17 | $537.03 |
United Setting Professional Modifier None Typical Low $177.83 Median $194.98 Typical High $295.12 | Professional | None | $177.83 | $194.98 | $295.12 |
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 $81.28 Median $97.72 Typical High $97.72 | Professional | 52 · Reduced service | $81.28 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $38.90 Typical High $38.90 | Professional | 53 · Discontinued | $32.36 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $29.51 Typical High $29.51 | Professional | 55 · Aftercare only | $23.99 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $19.50 Typical High $19.50 | Professional | 56 · Pre-op care only | $16.22 | $19.50 | $19.50 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $24.55 Median $24.55 Typical High $31.62 | Professional | RR · Rental | $24.55 | $24.55 | $31.62 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $181.97 Median $186.21 Typical High $186.21 | Professional | UE · Used equipment | $181.97 | $186.21 | $186.21 |
Where Virginia sits
The same service costs 2.9 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· 36th of 51
$240
MT $513DE $178
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.