How much rates vary
Facilitymedian $1,000 · 10th to 90th $794 to $2,239Professionalmedian $912 · 10th to 90th $661 to $1,318
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 $758.58 Median $758.58 Typical High $776.25 | Facility | None | $758.58 | $758.58 | $776.25 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $776.25 | Professional | None | $758.58 | $758.58 | $776.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,548.82 | Facility | None | $1,479.11 | $1,479.11 | $1,548.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,202.26 | Professional | None | $912.01 | $912.01 | $1,202.26 |
CareFirst Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,000.00 | Professional | None | $776.25 | $776.25 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $912.01 Typical High $912.01 | Facility | None | $831.76 | $912.01 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $912.01 | Professional | None | $660.69 | $660.69 | $912.01 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,023.29 Median $1,479.11 Typical High $1,905.46 | Professional | None | $1,023.29 | $1,479.11 | $1,905.46 |
Medcost Setting Professional Modifier None Typical Low $870.96 Median $954.99 Typical High $1,348.96 | Professional | None | $870.96 | $954.99 | $1,348.96 |
Medcost Setting Facility Modifier None Typical Low $512.86 Median $794.33 Typical High $954.99 | Facility | None | $512.86 | $794.33 | $954.99 |
Medcost Setting Professional Modifier None Typical Low $645.65 Median $851.14 Typical High $954.99 | Professional | None | $645.65 | $851.14 | $954.99 |
Sentara Setting Facility Modifier None Typical Low $724.44 Median $1,023.29 Typical High $3,162.28 | Facility | None | $724.44 | $1,023.29 | $3,162.28 |
Sentara Setting Professional Modifier None Typical Low $794.33 Median $1,096.48 Typical High $2,238.72 | Professional | None | $794.33 | $1,096.48 | $2,238.72 |
United Setting Facility Modifier None Typical Low $812.83 Median $954.99 Typical High $1,949.84 | Facility | None | $812.83 | $954.99 | $1,949.84 |
United Setting Professional Modifier None Typical Low $676.08 Median $724.44 Typical High $1,122.02 | Professional | None | $676.08 | $724.44 | $1,122.02 |
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 $380.19 Median $380.19 Typical High $389.05 | Professional | 52 · Reduced service | $380.19 | $380.19 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $154.88 | Professional | 53 · Discontinued | $151.36 | $151.36 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $77.62 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $77.62 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $91.20 Median $91.20 Typical High $114.82 | Professional | RR · Rental | $91.20 | $91.20 | $114.82 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $660.69 Median $676.08 Typical High $707.95 | Professional | UE · Used equipment | $660.69 | $676.08 | $707.95 |
Where Virginia sits
The same service costs 3.2 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· 28th of 51
$912
HI $2,138DE $661
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.