How much rates vary
Facilitymedian $219 · 10th to 90th $151 to $468Professionalmedian $162 · 10th to 90th $126 to $251
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 $151.36 Typical High $151.36 | Facility | None | $123.03 | $151.36 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $151.36 Typical High $151.36 | Professional | None | $123.03 | $151.36 | $151.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $331.13 | Facility | None | $309.03 | $309.03 | $331.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $186.21 | Professional | None | $162.18 | $162.18 | $186.21 |
CareFirst Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $213.80 | Professional | None | $162.18 | $162.18 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $169.82 Typical High $169.82 | Facility | None | $162.18 | $169.82 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $169.82 | Professional | None | $125.89 | $125.89 | $169.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $218.78 Median $309.03 Typical High $398.11 | Professional | None | $218.78 | $309.03 | $398.11 |
Medcost Setting Professional Modifier None Typical Low $181.97 Median $204.17 Typical High $281.84 | Professional | None | $181.97 | $204.17 | $281.84 |
Medcost Setting Facility Modifier None Typical Low $97.72 Median $165.96 Typical High $199.53 | Facility | None | $97.72 | $165.96 | $199.53 |
Medcost Setting Professional Modifier None Typical Low $141.25 Median $165.96 Typical High $389.05 | Professional | None | $141.25 | $165.96 | $389.05 |
Sentara Setting Facility Modifier None Typical Low $151.36 Median $213.80 Typical High $660.69 | Facility | None | $151.36 | $213.80 | $660.69 |
Sentara Setting Professional Modifier None Typical Low $165.96 Median $229.09 Typical High $467.74 | Professional | None | $165.96 | $229.09 | $467.74 |
United Setting Facility Modifier None Typical Low $181.97 Median $229.09 Typical High $371.54 | Facility | None | $181.97 | $229.09 | $371.54 |
United Setting Professional Modifier None Typical Low $138.04 Median $151.36 Typical High $229.09 | Professional | None | $138.04 | $151.36 | $229.09 |
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 $30.20 Typical High $30.20 | Professional | 53 · Discontinued | $24.55 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $22.39 Typical High $22.39 | Professional | 55 · Aftercare only | $18.62 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $15.14 Typical High $15.14 | Professional | 56 · Pre-op care only | $12.30 | $15.14 | $15.14 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $16.98 Median $16.98 Typical High $21.38 | Professional | RR · Rental | $16.98 | $16.98 | $21.38 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $123.03 Median $125.89 Typical High $125.89 | Professional | UE · Used equipment | $123.03 | $125.89 | $125.89 |
Where Virginia sits
The same service costs 4.7 times more in Hawaii than in Delaware. 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· 36th of 51
$162
HI $589DE $126
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.