How much rates vary
Facilitymedian $269 · 10th to 90th $186 to $575Professionalmedian $224 · 10th to 90th $174 to $316
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 $154.88 Median $186.21 Typical High $186.21 | Facility | None | $154.88 | $186.21 | $186.21 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $186.21 Typical High $186.21 | Professional | None | $154.88 | $186.21 | $186.21 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $407.38 | Facility | None | $389.05 | $389.05 | $407.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $251.19 | Professional | None | $223.87 | $223.87 | $251.19 |
CareFirst Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $263.03 | Professional | None | $204.17 | $204.17 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $234.42 Typical High $234.42 | Facility | None | $204.17 | $234.42 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $234.42 | Professional | None | $173.78 | $173.78 | $234.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $269.15 Median $389.05 Typical High $501.19 | Professional | None | $269.15 | $389.05 | $501.19 |
Medcost Setting Professional Modifier None Typical Low $229.09 Median $251.19 Typical High $354.81 | Professional | None | $229.09 | $251.19 | $354.81 |
Medcost Setting Facility Modifier None Typical Low $134.90 Median $208.93 Typical High $251.19 | Facility | None | $134.90 | $208.93 | $251.19 |
Medcost Setting Professional Modifier None Typical Low $208.93 Median $223.87 Typical High $478.63 | Professional | None | $208.93 | $223.87 | $478.63 |
Sentara Setting Facility Modifier None Typical Low $186.21 Median $269.15 Typical High $831.76 | Facility | None | $186.21 | $269.15 | $831.76 |
Sentara Setting Professional Modifier None Typical Low $208.93 Median $281.84 Typical High $575.44 | Professional | None | $208.93 | $281.84 | $575.44 |
United Setting Facility Modifier None Typical Low $251.19 Median $380.19 Typical High $512.86 | Facility | None | $251.19 | $380.19 | $512.86 |
United Setting Professional Modifier None Typical Low $169.82 Median $190.55 Typical High $281.84 | Professional | None | $169.82 | $190.55 | $281.84 |
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 $77.62 Median $93.33 Typical High $93.33 | Professional | 52 · Reduced service | $77.62 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $37.15 Typical High $37.15 | Professional | 53 · Discontinued | $30.90 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $28.18 Typical High $28.18 | Professional | 55 · Aftercare only | $23.44 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $18.62 Typical High $18.62 | Professional | 56 · Pre-op care only | $15.49 | $18.62 | $18.62 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $22.91 Median $22.91 Typical High $29.51 | Professional | RR · Rental | $22.91 | $22.91 | $29.51 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $165.96 Median $169.82 Typical High $177.83 | Professional | UE · Used equipment | $165.96 | $169.82 | $177.83 |
Where Virginia sits
The same service costs 5.5 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· 39th of 51
$224
HI $955FL $174
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.