How much rates vary
Facilitymedian $363 · 10th to 90th $245 to $794Professionalmedian $295 · 10th to 90th $224 to $427
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 $269.15 Median $269.15 Typical High $275.42 | Facility | None | $269.15 | $269.15 | $275.42 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $275.42 | Professional | None | $269.15 | $269.15 | $275.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $562.34 | Facility | None | $524.81 | $524.81 | $562.34 |
Anthem BCBS Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $338.84 | Professional | None | $295.12 | $295.12 | $338.84 |
CareFirst Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $363.08 | Professional | None | $275.42 | $275.42 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $309.03 Typical High $309.03 | Facility | None | $275.42 | $309.03 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $309.03 | Professional | None | $223.87 | $223.87 | $309.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $371.54 Median $524.81 Typical High $676.08 | Professional | None | $371.54 | $524.81 | $676.08 |
Medcost Setting Professional Modifier None Typical Low $323.59 Median $346.74 Typical High $478.63 | Professional | None | $323.59 | $346.74 | $478.63 |
Medcost Setting Facility Modifier None Typical Low $173.78 Median $281.84 Typical High $338.84 | Facility | None | $173.78 | $281.84 | $338.84 |
Medcost Setting Professional Modifier None Typical Low $245.47 Median $281.84 Typical High $338.84 | Professional | None | $245.47 | $281.84 | $338.84 |
Sentara Setting Facility Modifier None Typical Low $257.04 Median $363.08 Typical High $1,122.02 | Facility | None | $257.04 | $363.08 | $1,122.02 |
Sentara Setting Professional Modifier None Typical Low $281.84 Median $389.05 Typical High $794.33 | Professional | None | $281.84 | $389.05 | $794.33 |
United Setting Facility Modifier None Typical Low $138.04 Median $245.47 Typical High $660.69 | Facility | None | $138.04 | $245.47 | $660.69 |
United Setting Professional Modifier None Typical Low $239.88 Median $257.04 Typical High $389.05 | Professional | None | $239.88 | $257.04 | $389.05 |
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 $134.90 Median $134.90 Typical High $138.04 | Professional | 52 · Reduced service | $134.90 | $134.90 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | 53 · Discontinued | $54.95 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | 55 · Aftercare only | $40.74 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $27.54 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $27.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $30.20 Median $30.20 Typical High $38.90 | Professional | RR · Rental | $30.20 | $30.20 | $38.90 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $223.87 Median $229.09 Typical High $239.88 | Professional | UE · Used equipment | $223.87 | $229.09 | $239.88 |
Where Virginia sits
The same service costs 2.7 times more in Montana 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· 40th of 51
$295
MT $603DE $224
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.