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 $281.84 Median $281.84 Typical High $288.40 | Facility | None | $281.84 | $281.84 | $288.40 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $288.40 | Professional | None | $281.84 | $281.84 | $288.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $588.84 | Facility | None | $549.54 | $549.54 | $588.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $363.08 | Professional | None | $323.59 | $323.59 | $363.08 |
CareFirst Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $380.19 | Professional | None | $288.40 | $288.40 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $398.11 Typical High $398.11 | Facility | None | $288.40 | $398.11 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $398.11 | Professional | None | $288.40 | $288.40 | $398.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $389.05 Median $549.54 Typical High $707.95 | Professional | None | $389.05 | $549.54 | $707.95 |
Medcost Setting Professional Modifier None Typical Low $323.59 Median $363.08 Typical High $501.19 | Professional | None | $323.59 | $363.08 | $501.19 |
Medcost Setting Facility Modifier None Typical Low $190.55 Median $295.12 Typical High $354.81 | Facility | None | $190.55 | $295.12 | $354.81 |
Medcost Setting Professional Modifier None Typical Low $245.47 Median $302.00 Typical High $354.81 | Professional | None | $245.47 | $302.00 | $354.81 |
Sentara Setting Facility Modifier None Typical Low $269.15 Median $380.19 Typical High $1,174.90 | Facility | None | $269.15 | $380.19 | $1,174.90 |
Sentara Setting Professional Modifier None Typical Low $295.12 Median $407.38 Typical High $831.76 | Professional | None | $295.12 | $407.38 | $831.76 |
United Setting Facility Modifier None Typical Low $281.84 Median $331.13 Typical High $724.44 | Facility | None | $281.84 | $331.13 | $724.44 |
United Setting Professional Modifier None Typical Low $251.19 Median $269.15 Typical High $416.87 | Professional | None | $251.19 | $269.15 | $416.87 |
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 $141.25 Median $141.25 Typical High $144.54 | Professional | 52 · Reduced service | $141.25 | $141.25 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $56.23 Typical High $57.54 | Professional | 53 · Discontinued | $56.23 | $56.23 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | 55 · Aftercare only | $42.66 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.18 Typical High $28.84 | Professional | 56 · Pre-op care only | $28.18 | $28.18 | $28.84 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $33.11 Median $33.11 Typical High $42.66 | Professional | RR · Rental | $33.11 | $33.11 | $42.66 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $239.88 Median $251.19 Typical High $263.03 | Professional | UE · Used equipment | $239.88 | $251.19 | $263.03 |
Where Virginia sits
The same service costs 2.6 times more in Hawaii than in Washington, DC. 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
$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.