How much rates vary
Facilitymedian $282 · 10th to 90th $170 to $631Professionalmedian $204 · 10th to 90th $158 to $339
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 $165.96 Median $199.53 Typical High $199.53 | Facility | None | $165.96 | $199.53 | $199.53 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $199.53 Typical High $199.53 | Professional | None | $165.96 | $199.53 | $199.53 |
Anthem BCBS Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $436.52 | Facility | None | $416.87 | $416.87 | $436.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $251.19 | Professional | None | $204.17 | $204.17 | $251.19 |
CareFirst Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $281.84 | Professional | None | $218.78 | $218.78 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $218.78 | Professional | None | $158.49 | $158.49 | $218.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $288.40 Median $416.87 Typical High $537.03 | Professional | None | $288.40 | $416.87 | $537.03 |
Medcost Setting Professional Modifier None Typical Low $245.47 Median $269.15 Typical High $380.19 | Professional | None | $245.47 | $269.15 | $380.19 |
Medcost Setting Facility Modifier None Typical Low $120.23 Median $223.87 Typical High $269.15 | Facility | None | $120.23 | $223.87 | $269.15 |
Medcost Setting Professional Modifier None Typical Low $199.53 Median $251.19 Typical High $512.86 | Professional | None | $199.53 | $251.19 | $512.86 |
Sentara Setting Facility Modifier None Typical Low $204.17 Median $288.40 Typical High $891.25 | Facility | None | $204.17 | $288.40 | $891.25 |
Sentara Setting Professional Modifier None Typical Low $223.87 Median $302.00 Typical High $630.96 | Professional | None | $223.87 | $302.00 | $630.96 |
United Setting Facility Modifier None Typical Low $36.31 Median $169.82 Typical High $457.09 | Facility | None | $36.31 | $169.82 | $457.09 |
United Setting Professional Modifier None Typical Low $169.82 Median $204.17 Typical High $309.03 | Professional | None | $169.82 | $204.17 | $309.03 |
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 $83.18 Median $100.00 Typical High $100.00 | Professional | 52 · Reduced service | $83.18 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $39.81 Typical High $39.81 | Professional | 53 · Discontinued | $33.11 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $30.20 Typical High $30.20 | Professional | 55 · Aftercare only | $25.12 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $19.95 Typical High $19.95 | Professional | 56 · Pre-op care only | $16.60 | $19.95 | $19.95 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $20.42 Median $20.42 Typical High $27.54 | Professional | RR · Rental | $20.42 | $20.42 | $27.54 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $154.88 Median $154.88 Typical High $165.96 | Professional | UE · Used equipment | $154.88 | $154.88 | $165.96 |
Where Virginia sits
The same service costs 3.6 times more in Georgia than in Alaska. 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· 41st of 51
$204
GA $372AK $102
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.