How much rates vary
Facilitymedian $355 · 10th to 90th $240 to $741Professionalmedian $263 · 10th to 90th $234 to $398
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 $199.53 Median $239.88 Typical High $239.88 | Facility | None | $199.53 | $239.88 | $239.88 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $239.88 Typical High $263.03 | Professional | None | $199.53 | $239.88 | $263.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $524.81 | Facility | None | $489.78 | $489.78 | $524.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $295.12 | Professional | None | $263.03 | $263.03 | $295.12 |
CareFirst Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $338.84 | Professional | None | $257.04 | $257.04 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $239.88 Median $346.74 Typical High $346.74 | Facility | None | $239.88 | $346.74 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $346.74 | Professional | None | $251.19 | $251.19 | $346.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $346.74 Median $489.78 Typical High $645.65 | Professional | None | $346.74 | $489.78 | $645.65 |
Medcost Setting Professional Modifier None Typical Low $295.12 Median $323.59 Typical High $457.09 | Professional | None | $295.12 | $323.59 | $457.09 |
Medcost Setting Facility Modifier None Typical Low $158.49 Median $263.03 Typical High $323.59 | Facility | None | $158.49 | $263.03 | $323.59 |
Medcost Setting Professional Modifier None Typical Low $251.19 Median $263.03 Typical High $616.60 | Professional | None | $251.19 | $263.03 | $616.60 |
Sentara Setting Facility Modifier None Typical Low $239.88 Median $338.84 Typical High $1,071.52 | Facility | None | $239.88 | $338.84 | $1,071.52 |
Sentara Setting Professional Modifier None Typical Low $263.03 Median $363.08 Typical High $741.31 | Professional | None | $263.03 | $363.08 | $741.31 |
United Setting Facility Modifier None Typical Low $295.12 Median $389.05 Typical High $602.56 | Facility | None | $295.12 | $389.05 | $602.56 |
United Setting Professional Modifier None Typical Low $218.78 Median $239.88 Typical High $363.08 | Professional | None | $218.78 | $239.88 | $363.08 |
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 $120.23 Typical High $120.23 | Professional | 52 · Reduced service | $100.00 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $47.86 Typical High $47.86 | Professional | 53 · Discontinued | $39.81 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $36.31 Typical High $36.31 | Professional | 55 · Aftercare only | $29.51 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $23.99 Typical High $23.99 | Professional | 56 · Pre-op care only | $19.95 | $23.99 | $23.99 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $26.92 Median $26.92 Typical High $34.67 | Professional | RR · Rental | $26.92 | $26.92 | $34.67 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $194.98 Median $204.17 Typical High $213.80 | Professional | UE · Used equipment | $194.98 | $204.17 | $213.80 |
Where Virginia sits
The same service costs 3.8 times more in Hawaii than in Florida. 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· 38th of 51
$263
HI $912FL $240
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.