How much rates vary
Facilitymedian $407 · 10th to 90th $275 to $851Professionalmedian $251 · 10th to 90th $229 to $447
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 $223.87 Median $275.42 Typical High $275.42 | Facility | None | $223.87 | $275.42 | $275.42 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $275.42 Typical High $380.19 | Professional | None | $223.87 | $275.42 | $380.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $602.56 | Facility | None | $562.34 | $562.34 | $602.56 |
Anthem BCBS Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $275.42 | Professional | None | $229.09 | $229.09 | $275.42 |
CareFirst Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $389.05 | Professional | None | $338.84 | $338.84 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $316.23 Typical High $316.23 | Facility | None | $245.47 | $316.23 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $316.23 | Professional | None | $229.09 | $229.09 | $316.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $398.11 Median $562.34 Typical High $724.44 | Professional | None | $398.11 | $562.34 | $724.44 |
Medcost Setting Professional Modifier None Typical Low $331.13 Median $371.54 Typical High $512.86 | Professional | None | $331.13 | $371.54 | $512.86 |
Medcost Setting Facility Modifier None Typical Low $177.83 Median $302.00 Typical High $363.08 | Facility | None | $177.83 | $302.00 | $363.08 |
Medcost Setting Professional Modifier None Typical Low $288.40 Median $302.00 Typical High $707.95 | Professional | None | $288.40 | $302.00 | $707.95 |
Sentara Setting Facility Modifier None Typical Low $275.42 Median $398.11 Typical High $1,202.26 | Facility | None | $275.42 | $398.11 | $1,202.26 |
Sentara Setting Professional Modifier None Typical Low $302.00 Median $416.87 Typical High $851.14 | Professional | None | $302.00 | $416.87 | $851.14 |
United Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $831.76 | Facility | None | $691.83 | $691.83 | $831.76 |
United Setting Professional Modifier None Typical Low $251.19 Median $275.42 Typical High $416.87 | Professional | None | $251.19 | $275.42 | $416.87 |
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 $112.20 Median $134.90 Typical High $134.90 | Professional | 52 · Reduced service | $112.20 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $54.95 Typical High $54.95 | Professional | 53 · Discontinued | $44.67 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $40.74 Typical High $40.74 | Professional | 55 · Aftercare only | $33.88 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $27.54 Typical High $27.54 | Professional | 56 · Pre-op care only | $22.39 | $27.54 | $27.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $23.44 Median $23.44 Typical High $39.81 | Professional | RR · Rental | $23.44 | $23.44 | $39.81 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $177.83 Median $177.83 Typical High $199.53 | Professional | UE · Used equipment | $177.83 | $177.83 | $199.53 |
Where Virginia sits
The same service costs 2.6 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· 47th of 51
$275
MT $589DE $229
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.