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 $1,202.26 Median $1,202.26 Typical High $1,202.26 | Facility | None | $1,202.26 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,454.71 | Facility | None | $2,344.23 | $2,344.23 | $2,454.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,479.11 | Professional | None | $1,318.26 | $1,318.26 | $1,479.11 |
CareFirst Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,584.89 | Professional | None | $1,230.27 | $1,230.27 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $1,584.89 Typical High $1,584.89 | Facility | None | $1,071.52 | $1,584.89 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,584.89 | Professional | None | $1,174.90 | $1,174.90 | $1,584.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,621.81 Median $2,344.23 Typical High $3,019.95 | Professional | None | $1,621.81 | $2,344.23 | $3,019.95 |
Medcost Setting Professional Modifier None Typical Low $1,380.38 Median $1,513.56 Typical High $2,137.96 | Professional | None | $1,380.38 | $1,513.56 | $2,137.96 |
Medcost Setting Facility Modifier None Typical Low $776.25 Median $1,258.93 Typical High $1,513.56 | Facility | None | $776.25 | $1,258.93 | $1,513.56 |
Medcost Setting Professional Modifier None Typical Low $977.24 Median $1,258.93 Typical High $1,513.56 | Professional | None | $977.24 | $1,258.93 | $1,513.56 |
Sentara Setting Facility Modifier None Typical Low $1,096.48 Median $1,584.89 Typical High $4,786.30 | Facility | None | $1,096.48 | $1,584.89 | $4,786.30 |
Sentara Setting Professional Modifier None Typical Low $1,258.93 Median $1,698.24 Typical High $3,467.37 | Professional | None | $1,258.93 | $1,698.24 | $3,467.37 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $1,445.44 Typical High $2,951.21 | Facility | None | $1,258.93 | $1,445.44 | $2,951.21 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,122.02 Typical High $1,698.24 | Professional | None | $1,047.13 | $1,122.02 | $1,698.24 |
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 $602.56 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $602.56 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $239.88 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $181.97 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $120.23 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $134.90 Median $134.90 Typical High $173.78 | Professional | RR · Rental | $134.90 | $134.90 | $173.78 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $977.24 Median $1,023.29 Typical High $1,071.52 | Professional | UE · Used equipment | $977.24 | $1,023.29 | $1,071.52 |
Where Virginia sits
The same service costs 2.7 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· 39th of 51
$1,318
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.