How much rates vary
Facilitymedian $437 · 10th to 90th $263 to $977Professionalmedian $339 · 10th to 90th $251 to $575
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 $331.13 Median $331.13 Typical High $338.84 | Facility | None | $331.13 | $331.13 | $338.84 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $331.13 Typical High $338.84 | Professional | None | $302.00 | $331.13 | $338.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $691.83 | Facility | None | $645.65 | $645.65 | $691.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $257.04 Median $389.05 Typical High $512.86 | Professional | None | $257.04 | $389.05 | $512.86 |
CareFirst Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $446.68 | Professional | None | $338.84 | $338.84 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $346.74 Typical High $346.74 | Facility | None | $229.09 | $346.74 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $346.74 | Professional | None | $251.19 | $251.19 | $346.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $457.09 Median $645.65 Typical High $831.76 | Professional | None | $457.09 | $645.65 | $831.76 |
Medcost Setting Professional Modifier None Typical Low $380.19 Median $426.58 Typical High $588.84 | Professional | None | $380.19 | $426.58 | $588.84 |
Medcost Setting Facility Modifier None Typical Low $177.83 Median $346.74 Typical High $416.87 | Facility | None | $177.83 | $346.74 | $416.87 |
Medcost Setting Professional Modifier None Typical Low $223.87 Median $302.00 Typical High $416.87 | Professional | None | $223.87 | $302.00 | $416.87 |
Sentara Setting Facility Modifier None Typical Low $316.23 Median $446.68 Typical High $1,380.38 | Facility | None | $316.23 | $446.68 | $1,380.38 |
Sentara Setting Professional Modifier None Typical Low $346.74 Median $478.63 Typical High $977.24 | Professional | None | $346.74 | $478.63 | $977.24 |
United Setting Facility Modifier None Typical Low $173.78 Median $251.19 Typical High $676.08 | Facility | None | $173.78 | $251.19 | $676.08 |
United Setting Professional Modifier None Typical Low $281.84 Median $316.23 Typical High $478.63 | Professional | None | $281.84 | $316.23 | $478.63 |
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 $151.36 Median $165.96 Typical High $169.82 | Professional | 52 · Reduced service | $151.36 | $165.96 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $66.07 Typical High $67.61 | Professional | 53 · Discontinued | $60.26 | $66.07 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $44.67 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $33.11 Typical High $33.88 | Professional | 56 · Pre-op care only | $30.20 | $33.11 | $33.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $30.20 Median $30.20 Typical High $39.81 | Professional | RR · Rental | $30.20 | $30.20 | $39.81 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $229.09 Median $229.09 Typical High $245.47 | Professional | UE · Used equipment | $229.09 | $229.09 | $245.47 |
Where Virginia sits
The same service costs 2.9 times more in Iowa than in Kansas. 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· 22nd of 51
$347
IA $603KS $209
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.