How much rates vary
Facilitymedian $575 · 10th to 90th $389 to $1,230Professionalmedian $537 · 10th to 90th $398 to $692
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 $331.13 Median $398.11 Typical High $398.11 | Facility | None | $331.13 | $398.11 | $398.11 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $398.11 Typical High $478.63 | Professional | None | $331.13 | $398.11 | $478.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $870.96 | Facility | None | $812.83 | $812.83 | $870.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $602.56 | Professional | None | $537.03 | $537.03 | $602.56 |
CareFirst Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $562.34 | Professional | None | $426.58 | $426.58 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $549.54 Typical High $549.54 | Facility | None | $426.58 | $549.54 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $549.54 | Professional | None | $398.11 | $398.11 | $549.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $575.44 Median $812.83 Typical High $1,071.52 | Professional | None | $575.44 | $812.83 | $1,071.52 |
Medcost Setting Professional Modifier None Typical Low $478.63 Median $537.03 Typical High $741.31 | Professional | None | $478.63 | $537.03 | $741.31 |
Medcost Setting Facility Modifier None Typical Low $281.84 Median $436.52 Typical High $537.03 | Facility | None | $281.84 | $436.52 | $537.03 |
Medcost Setting Professional Modifier None Typical Low $436.52 Median $489.78 Typical High $1,023.29 | Professional | None | $436.52 | $489.78 | $1,023.29 |
Sentara Setting Facility Modifier None Typical Low $398.11 Median $575.44 Typical High $1,737.80 | Facility | None | $398.11 | $575.44 | $1,737.80 |
Sentara Setting Professional Modifier None Typical Low $436.52 Median $602.56 Typical High $1,230.27 | Professional | None | $436.52 | $602.56 | $1,230.27 |
United Setting Facility Modifier None Typical Low $331.13 Median $436.52 Typical High $1,096.48 | Facility | None | $331.13 | $436.52 | $1,096.48 |
United Setting Professional Modifier None Typical Low $363.08 Median $398.11 Typical High $602.56 | Professional | None | $363.08 | $398.11 | $602.56 |
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 $162.18 Median $199.53 Typical High $208.93 | Professional | 52 · Reduced service | $162.18 | $199.53 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $79.43 Typical High $83.18 | Professional | 53 · Discontinued | $66.07 | $79.43 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $58.88 Typical High $61.66 | Professional | 55 · Aftercare only | $48.98 | $58.88 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $39.81 Typical High $41.69 | Professional | 56 · Pre-op care only | $33.11 | $39.81 | $41.69 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $54.95 Median $54.95 Typical High $64.57 | Professional | RR · Rental | $54.95 | $54.95 | $64.57 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $407.38 Median $416.87 Typical High $436.52 | Professional | UE · Used equipment | $407.38 | $416.87 | $436.52 |
Where Virginia sits
The same service costs 2.4 times more in Iowa 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
$537
IA $955DE $398
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.