How much rates vary
Facilitymedian $617 · 10th to 90th $437 to $1,349Professionalmedian $501 · 10th to 90th $363 to $794
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 $363.08 Median $436.52 Typical High $436.52 | Facility | None | $363.08 | $436.52 | $436.52 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $436.52 Typical High $436.52 | Professional | None | $363.08 | $436.52 | $436.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $954.99 | Facility | None | $912.01 | $912.01 | $954.99 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $676.08 | Professional | None | $501.19 | $501.19 | $676.08 |
CareFirst Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $616.60 | Professional | None | $478.63 | $478.63 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $501.19 Typical High $501.19 | Facility | None | $398.11 | $501.19 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $501.19 | Professional | None | $363.08 | $363.08 | $501.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $630.96 Median $912.01 Typical High $1,174.90 | Professional | None | $630.96 | $912.01 | $1,174.90 |
Medcost Setting Professional Modifier None Typical Low $537.03 Median $588.84 Typical High $831.76 | Professional | None | $537.03 | $588.84 | $831.76 |
Medcost Setting Facility Modifier None Typical Low $281.84 Median $489.78 Typical High $588.84 | Facility | None | $281.84 | $489.78 | $588.84 |
Medcost Setting Professional Modifier None Typical Low $426.58 Median $489.78 Typical High $1,122.02 | Professional | None | $426.58 | $489.78 | $1,122.02 |
Sentara Setting Facility Modifier None Typical Low $436.52 Median $616.60 Typical High $1,949.84 | Facility | None | $436.52 | $616.60 | $1,949.84 |
Sentara Setting Professional Modifier None Typical Low $489.78 Median $660.69 Typical High $1,348.96 | Professional | None | $489.78 | $660.69 | $1,348.96 |
United Setting Facility Modifier None Typical Low $537.03 Median $562.34 Typical High $1,096.48 | Facility | None | $537.03 | $562.34 | $1,096.48 |
United Setting Professional Modifier None Typical Low $398.11 Median $446.68 Typical High $660.69 | Professional | None | $398.11 | $446.68 | $660.69 |
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 $181.97 Median $218.78 Typical High $218.78 | Professional | 52 · Reduced service | $181.97 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $72.44 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $66.07 Typical High $66.07 | Professional | 55 · Aftercare only | $54.95 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $43.65 Typical High $43.65 | Professional | 56 · Pre-op care only | $36.31 | $43.65 | $43.65 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $50.12 Median $50.12 Typical High $64.57 | Professional | RR · Rental | $50.12 | $50.12 | $64.57 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $363.08 Median $380.19 Typical High $380.19 | Professional | UE · Used equipment | $363.08 | $380.19 | $380.19 |
Where Virginia sits
The same service costs 3.9 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· 26th of 51
$501
HI $1,413DE $363
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.