How much rates vary
Facilitymedian $204 · 10th to 90th $141 to $437Professionalmedian $138 · 10th to 90th $120 to $234
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 $117.49 Median $141.25 Typical High $141.25 | Facility | None | $117.49 | $141.25 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $141.25 Typical High $141.25 | Professional | None | $117.49 | $141.25 | $141.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $309.03 | Facility | None | $295.12 | $295.12 | $309.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $169.82 | Professional | None | $138.04 | $138.04 | $169.82 |
CareFirst Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $199.53 | Professional | None | $154.88 | $154.88 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $165.96 Typical High $165.96 | Facility | None | $151.36 | $165.96 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $165.96 | Professional | None | $120.23 | $120.23 | $165.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $204.17 Median $295.12 Typical High $380.19 | Professional | None | $204.17 | $295.12 | $380.19 |
Medcost Setting Professional Modifier None Typical Low $173.78 Median $190.55 Typical High $269.15 | Professional | None | $173.78 | $190.55 | $269.15 |
Medcost Setting Facility Modifier None Typical Low $81.28 Median $158.49 Typical High $190.55 | Facility | None | $81.28 | $158.49 | $190.55 |
Medcost Setting Professional Modifier None Typical Low $102.33 Median $138.04 Typical High $363.08 | Professional | None | $102.33 | $138.04 | $363.08 |
Sentara Setting Facility Modifier None Typical Low $141.25 Median $199.53 Typical High $630.96 | Facility | None | $141.25 | $199.53 | $630.96 |
Sentara Setting Professional Modifier None Typical Low $158.49 Median $213.80 Typical High $436.52 | Professional | None | $158.49 | $213.80 | $436.52 |
United Setting Facility Modifier None Typical Low $154.88 Median $213.80 Typical High $316.23 | Facility | None | $154.88 | $213.80 | $316.23 |
United Setting Professional Modifier None Typical Low $114.82 Median $141.25 Typical High $213.80 | Professional | None | $114.82 | $141.25 | $213.80 |
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 $58.88 Median $70.79 Typical High $70.79 | Professional | 52 · Reduced service | $58.88 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $28.18 Typical High $28.18 | Professional | 53 · Discontinued | $23.44 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $21.38 Typical High $21.38 | Professional | 55 · Aftercare only | $17.38 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $14.13 Typical High $14.13 | Professional | 56 · Pre-op care only | $11.75 | $14.13 | $14.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $13.80 Median $13.80 Typical High $18.62 | Professional | RR · Rental | $13.80 | $13.80 | $18.62 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | UE · Used equipment | $102.33 | $102.33 | $102.33 |
Where Virginia sits
The same service costs 4.4 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· 33rd of 51
$141
HI $525FL $120
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.