How much rates vary
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 $436.52 Median $537.03 Typical High $537.03 | Facility | None | $436.52 | $537.03 | $537.03 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $537.03 Typical High $537.03 | Professional | None | $436.52 | $537.03 | $537.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,174.90 | Facility | None | $1,096.48 | $1,096.48 | $1,174.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $891.25 | Professional | None | $676.08 | $676.08 | $891.25 |
CareFirst Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $758.58 | Professional | None | $575.44 | $575.44 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $616.60 Typical High $616.60 | Facility | None | $467.74 | $616.60 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $616.60 | Professional | None | $446.68 | $446.68 | $616.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $776.25 Median $1,096.48 Typical High $1,412.54 | Professional | None | $776.25 | $1,096.48 | $1,412.54 |
Medcost Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $794.33 | Facility | None | $602.56 | $602.56 | $794.33 |
Medcost Setting Professional Modifier None Typical Low $602.56 Median $660.69 Typical High $1,380.38 | Professional | None | $602.56 | $660.69 | $1,380.38 |
Sentara Setting Facility Modifier None Typical Low $602.56 Median $851.14 Typical High $1,659.59 | Facility | None | $602.56 | $851.14 | $1,659.59 |
Sentara Setting Professional Modifier None Typical Low $602.56 Median $851.14 Typical High $1,479.11 | Professional | None | $602.56 | $851.14 | $1,479.11 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,621.81 | Facility | None | $1,348.96 | $1,348.96 | $1,621.81 |
United Setting Professional Modifier None Typical Low $501.19 Median $537.03 Typical High $851.14 | Professional | None | $501.19 | $537.03 | $851.14 |
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 $218.78 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $218.78 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $107.15 Typical High $107.15 | Professional | 53 · Discontinued | $89.13 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $79.43 Typical High $79.43 | Professional | 55 · Aftercare only | $66.07 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $43.65 | $53.70 | $53.70 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $67.61 Median $67.61 Typical High $77.62 | Professional | RR · Rental | $67.61 | $67.61 | $77.62 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $489.78 Median $512.86 Typical High $537.03 | Professional | UE · Used equipment | $489.78 | $512.86 | $537.03 |
Where Virginia sits
The same service costs 2.6 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· 25th of 51
$676
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.