How much rates vary
Facilitymedian $257 · 10th to 90th $182 to $562Professionalmedian $219 · 10th to 90th $178 to $309
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 $151.36 Median $181.97 Typical High $181.97 | Facility | None | $151.36 | $181.97 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $181.97 Typical High $181.97 | Professional | None | $151.36 | $181.97 | $181.97 |
Anthem BCBS Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $398.11 | Facility | None | $371.54 | $371.54 | $398.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $269.15 | Professional | None | $218.78 | $218.78 | $269.15 |
CareFirst Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $257.04 | Professional | None | $194.98 | $194.98 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $245.47 Typical High $245.47 | Facility | None | $162.18 | $245.47 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $245.47 | Professional | None | $177.83 | $177.83 | $245.47 |
Kaiser Permanente Setting Professional Modifier None Typical Low $263.03 Median $371.54 Typical High $489.78 | Professional | None | $263.03 | $371.54 | $489.78 |
Medcost Setting Professional Modifier None Typical Low $218.78 Median $245.47 Typical High $338.84 | Professional | None | $218.78 | $245.47 | $338.84 |
Medcost Setting Facility Modifier None Typical Low $125.89 Median $199.53 Typical High $245.47 | Facility | None | $125.89 | $199.53 | $245.47 |
Medcost Setting Professional Modifier None Typical Low $158.49 Median $199.53 Typical High $467.74 | Professional | None | $158.49 | $199.53 | $467.74 |
Sentara Setting Facility Modifier None Typical Low $181.97 Median $257.04 Typical High $794.33 | Facility | None | $181.97 | $257.04 | $794.33 |
Sentara Setting Professional Modifier None Typical Low $199.53 Median $275.42 Typical High $562.34 | Professional | None | $199.53 | $275.42 | $562.34 |
United Setting Facility Modifier None Typical Low $199.53 Median $234.42 Typical High $478.63 | Facility | None | $199.53 | $234.42 | $478.63 |
United Setting Professional Modifier None Typical Low $165.96 Median $181.97 Typical High $275.42 | Professional | None | $165.96 | $181.97 | $275.42 |
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 $74.13 Median $91.20 Typical High $91.20 | Professional | 52 · Reduced service | $74.13 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $36.31 Typical High $36.31 | Professional | 53 · Discontinued | $30.20 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $26.92 Typical High $26.92 | Professional | 55 · Aftercare only | $22.39 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $18.20 Typical High $18.20 | Professional | 56 · Pre-op care only | $15.14 | $18.20 | $18.20 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $21.88 Median $21.88 Typical High $27.54 | Professional | RR · Rental | $21.88 | $21.88 | $27.54 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | UE · Used equipment | $162.18 | $162.18 | $162.18 |
Where Virginia sits
The same service costs 3.2 times more in Hawaii than in Alabama. 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· 31st of 51
$219
HI $562AL $178
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.