How much rates vary
Facilitymedian $525 · 10th to 90th $324 to $1,175Professionalmedian $398 · 10th to 90th $355 to $617
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 $398.11 Median $398.11 Typical High $407.38 | Facility | None | $398.11 | $398.11 | $407.38 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $398.11 Typical High $407.38 | Professional | None | $380.19 | $398.11 | $407.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $831.76 | Facility | None | $776.25 | $776.25 | $831.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $489.78 | Professional | None | $398.11 | $398.11 | $489.78 |
CareFirst Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $537.03 | Professional | None | $407.38 | $407.38 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $489.78 Typical High $489.78 | Facility | None | $323.59 | $489.78 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $489.78 | Professional | None | $354.81 | $354.81 | $489.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $537.03 Median $776.25 Typical High $1,000.00 | Professional | None | $537.03 | $776.25 | $1,000.00 |
Medcost Setting Professional Modifier None Typical Low $457.09 Median $512.86 Typical High $707.95 | Professional | None | $457.09 | $512.86 | $707.95 |
Medcost Setting Facility Modifier None Typical Low $234.42 Median $416.87 Typical High $501.19 | Facility | None | $234.42 | $416.87 | $501.19 |
Medcost Setting Professional Modifier None Typical Low $295.12 Median $389.05 Typical High $501.19 | Professional | None | $295.12 | $389.05 | $501.19 |
Sentara Setting Facility Modifier None Typical Low $380.19 Median $537.03 Typical High $1,659.59 | Facility | None | $380.19 | $537.03 | $1,659.59 |
Sentara Setting Professional Modifier None Typical Low $416.87 Median $575.44 Typical High $1,174.90 | Professional | None | $416.87 | $575.44 | $1,174.90 |
United Setting Facility Modifier None Typical Low $165.96 Median $323.59 Typical High $891.25 | Facility | None | $165.96 | $323.59 | $891.25 |
United Setting Professional Modifier None Typical Low $338.84 Median $380.19 Typical High $575.44 | Professional | None | $338.84 | $380.19 | $575.44 |
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 $194.98 Median $199.53 Typical High $204.17 | Professional | 52 · Reduced service | $194.98 | $199.53 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $79.43 Typical High $81.28 | Professional | 53 · Discontinued | $77.62 | $79.43 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $60.26 Typical High $60.26 | Professional | 55 · Aftercare only | $57.54 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $39.81 Typical High $40.74 | Professional | 56 · Pre-op care only | $38.90 | $39.81 | $40.74 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $39.81 Median $39.81 Typical High $51.29 | Professional | RR · Rental | $39.81 | $39.81 | $51.29 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $295.12 Median $295.12 Typical High $316.23 | Professional | UE · Used equipment | $295.12 | $295.12 | $316.23 |
Where Virginia sits
The same service costs 2.4 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· 35th of 51
$398
IA $776KS $324
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.