How much rates vary
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 $204.17 Median $245.47 Typical High $245.47 | Facility | None | $204.17 | $245.47 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $245.47 Typical High $245.47 | Professional | None | $204.17 | $245.47 | $245.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $537.03 | Facility | None | $501.19 | $501.19 | $537.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $371.54 | Professional | None | $302.00 | $302.00 | $371.54 |
CareFirst Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $346.74 | Professional | None | $263.03 | $263.03 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $257.04 Median $389.05 Typical High $389.05 | Facility | None | $257.04 | $389.05 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $389.05 | Professional | None | $281.84 | $281.84 | $389.05 |
Kaiser Permanente Setting Professional Modifier None Typical Low $354.81 Median $501.19 Typical High $660.69 | Professional | None | $354.81 | $501.19 | $660.69 |
Medcost Setting Professional Modifier None Typical Low $295.12 Median $331.13 Typical High $457.09 | Professional | None | $295.12 | $331.13 | $457.09 |
Medcost Setting Facility Modifier None Typical Low $173.78 Median $269.15 Typical High $331.13 | Facility | None | $173.78 | $269.15 | $331.13 |
Medcost Setting Professional Modifier None Typical Low $218.78 Median $295.12 Typical High $630.96 | Professional | None | $218.78 | $295.12 | $630.96 |
Sentara Setting Facility Modifier None Typical Low $245.47 Median $346.74 Typical High $1,071.52 | Facility | None | $245.47 | $346.74 | $1,071.52 |
Sentara Setting Professional Modifier None Typical Low $269.15 Median $371.54 Typical High $758.58 | Professional | None | $269.15 | $371.54 | $758.58 |
United Setting Facility Modifier None Typical Low $331.13 Median $426.58 Typical High $676.08 | Facility | None | $331.13 | $426.58 | $676.08 |
United Setting Professional Modifier None Typical Low $223.87 Median $245.47 Typical High $371.54 | Professional | None | $223.87 | $245.47 | $371.54 |
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 $100.00 Median $123.03 Typical High $123.03 | Professional | 52 · Reduced service | $100.00 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $48.98 Typical High $48.98 | Professional | 53 · Discontinued | $40.74 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $36.31 Typical High $36.31 | Professional | 55 · Aftercare only | $30.20 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $24.55 Typical High $24.55 | Professional | 56 · Pre-op care only | $20.42 | $24.55 | $24.55 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $30.20 Median $30.20 Typical High $39.81 | Professional | RR · Rental | $30.20 | $30.20 | $39.81 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | UE · Used equipment | $223.87 | $223.87 | $223.87 |
Where Virginia sits
The same service costs 3.4 times more in Hawaii than in Washington, DC. 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· 34th of 51
$302
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.