How much rates vary
Facilitymedian $209 · 10th to 90th $145 to $457Professionalmedian $155 · 10th to 90th $117 to $245
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 $123.03 Median $147.91 Typical High $147.91 | Facility | None | $123.03 | $147.91 | $147.91 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $147.91 Typical High $147.91 | Professional | None | $123.03 | $147.91 | $147.91 |
Anthem BCBS Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $323.59 | Facility | None | $309.03 | $309.03 | $323.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $190.55 | Professional | None | $154.88 | $154.88 | $190.55 |
CareFirst Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $208.93 | Professional | None | $162.18 | $162.18 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $158.49 Typical High $158.49 | Facility | None | $144.54 | $158.49 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $158.49 | Professional | None | $117.49 | $117.49 | $158.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $213.80 Median $309.03 Typical High $398.11 | Professional | None | $213.80 | $309.03 | $398.11 |
Medcost Setting Professional Modifier None Typical Low $181.97 Median $199.53 Typical High $281.84 | Professional | None | $181.97 | $199.53 | $281.84 |
Medcost Setting Facility Modifier None Typical Low $91.20 Median $165.96 Typical High $199.53 | Facility | None | $91.20 | $165.96 | $199.53 |
Medcost Setting Professional Modifier None Typical Low $114.82 Median $151.36 Typical High $380.19 | Professional | None | $114.82 | $151.36 | $380.19 |
Sentara Setting Facility Modifier None Typical Low $147.91 Median $208.93 Typical High $660.69 | Facility | None | $147.91 | $208.93 | $660.69 |
Sentara Setting Professional Modifier None Typical Low $165.96 Median $223.87 Typical High $457.09 | Professional | None | $165.96 | $223.87 | $457.09 |
United Setting Facility Modifier None Typical Low $141.25 Median $169.82 Typical High $346.74 | Facility | None | $141.25 | $169.82 | $346.74 |
United Setting Professional Modifier None Typical Low $128.82 Median $147.91 Typical High $223.87 | Professional | None | $128.82 | $147.91 | $223.87 |
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 $61.66 Median $74.13 Typical High $74.13 | Professional | 52 · Reduced service | $61.66 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $29.51 Typical High $29.51 | Professional | 53 · Discontinued | $24.55 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $22.39 Typical High $22.39 | Professional | 55 · Aftercare only | $18.20 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $14.79 Typical High $14.79 | Professional | 56 · Pre-op care only | $12.30 | $14.79 | $14.79 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $15.49 Median $15.49 Typical High $21.38 | Professional | RR · Rental | $15.49 | $15.49 | $21.38 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $117.49 Median $117.49 Typical High $125.89 | Professional | UE · Used equipment | $117.49 | $117.49 | $125.89 |
Where Virginia sits
The same service costs 4.4 times more in Hawaii than in Kansas. 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· 40th of 51
$155
HI $468KS $107
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.