How much rates vary
Facilitymedian $468 · 10th to 90th $324 to $1,000Professionalmedian $380 · 10th to 90th $295 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 $660.69 Median $660.69 Typical High $707.95 | Facility | None | $660.69 | $660.69 | $707.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $436.52 | Professional | None | $380.19 | $380.19 | $436.52 |
CareFirst Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $457.09 | Professional | None | $354.81 | $354.81 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $407.38 Typical High $407.38 | Facility | None | $316.23 | $407.38 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $407.38 | Professional | None | $295.12 | $295.12 | $407.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $467.74 Median $660.69 Typical High $870.96 | Professional | None | $467.74 | $660.69 | $870.96 |
Medcost Setting Professional Modifier None Typical Low $389.05 Median $436.52 Typical High $616.60 | Professional | None | $389.05 | $436.52 | $616.60 |
Medcost Setting Facility Modifier None Typical Low $229.09 Median $354.81 Typical High $436.52 | Facility | None | $229.09 | $354.81 | $436.52 |
Medcost Setting Professional Modifier None Typical Low $309.03 Median $398.11 Typical High $831.76 | Professional | None | $309.03 | $398.11 | $831.76 |
Sentara Setting Facility Modifier None Typical Low $323.59 Median $457.09 Typical High $1,445.44 | Facility | None | $323.59 | $457.09 | $1,445.44 |
Sentara Setting Professional Modifier None Typical Low $354.81 Median $489.78 Typical High $1,000.00 | Professional | None | $354.81 | $489.78 | $1,000.00 |
United Setting Facility Modifier None Typical Low $436.52 Median $575.44 Typical High $891.25 | Facility | None | $436.52 | $575.44 | $891.25 |
United Setting Professional Modifier None Typical Low $295.12 Median $323.59 Typical High $489.78 | Professional | None | $295.12 | $323.59 | $489.78 |
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 $169.82 | Professional | 52 · Reduced service | $134.90 | $162.18 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $64.57 Typical High $67.61 | Professional | 53 · Discontinued | $53.70 | $64.57 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $48.98 Typical High $50.12 | Professional | 55 · Aftercare only | $39.81 | $48.98 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $32.36 Typical High $33.88 | Professional | 56 · Pre-op care only | $26.92 | $32.36 | $33.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $39.81 Median $39.81 Typical High $51.29 | Professional | RR · Rental | $39.81 | $39.81 | $51.29 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $288.40 Median $295.12 Typical High $295.12 | Professional | UE · Used equipment | $288.40 | $295.12 | $295.12 |
Where Virginia sits
The same service costs 4.3 times more in Hawaii 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· 35th of 51
$380
HI $1,259DE $295
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.