How much rates vary
Facilitymedian $525 · 10th to 90th $331 to $1,023Professionalmedian $380 · 10th to 90th $331 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 $275.42 Median $331.13 Typical High $331.13 | Facility | None | $275.42 | $331.13 | $331.13 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $331.13 Typical High $331.13 | Professional | None | $275.42 | $331.13 | $331.13 |
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 $380.19 Median $380.19 Typical High $426.58 | Professional | None | $380.19 | $380.19 | $426.58 |
CareFirst Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $467.74 | Professional | None | $354.81 | $354.81 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $524.81 Typical High $524.81 | Facility | None | $323.59 | $524.81 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $524.81 | Professional | None | $380.19 | $380.19 | $524.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $478.63 Median $676.08 Typical High $891.25 | Professional | None | $478.63 | $676.08 | $891.25 |
Medcost Setting Professional Modifier None Typical Low $398.11 Median $446.68 Typical High $616.60 | Professional | None | $398.11 | $446.68 | $616.60 |
Medcost Setting Facility Modifier None Typical Low $218.78 Median $363.08 Typical High $446.68 | Facility | None | $218.78 | $363.08 | $446.68 |
Medcost Setting Professional Modifier None Typical Low $354.81 Median $371.54 Typical High $851.14 | Professional | None | $354.81 | $371.54 | $851.14 |
Sentara Setting Facility Modifier None Typical Low $331.13 Median $467.74 Typical High $1,445.44 | Facility | None | $331.13 | $467.74 | $1,445.44 |
Sentara Setting Professional Modifier None Typical Low $363.08 Median $501.19 Typical High $1,023.29 | Professional | None | $363.08 | $501.19 | $1,023.29 |
United Setting Facility Modifier None Typical Low $389.05 Median $416.87 Typical High $851.14 | Facility | None | $389.05 | $416.87 | $851.14 |
United Setting Professional Modifier None Typical Low $302.00 Median $331.13 Typical High $501.19 | Professional | None | $302.00 | $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 $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $134.90 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $66.07 Typical High $66.07 | Professional | 53 · Discontinued | $54.95 | $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 $27.54 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $27.54 | $33.11 | $33.11 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $38.90 Median $38.90 Typical High $48.98 | Professional | RR · Rental | $38.90 | $38.90 | $48.98 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $281.84 Median $288.40 Typical High $316.23 | Professional | UE · Used equipment | $281.84 | $288.40 | $316.23 |
Where Virginia sits
The same service costs 2.8 times more in Hawaii than in Maryland. 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
$380
HI $977MD $355
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.