How much rates vary
Facilitymedian $186 · 10th to 90th $138 to $407Professionalmedian $178 · 10th to 90th $120 to $229
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 $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $288.40 | Facility | None | $269.15 | $269.15 | $288.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $199.53 | Professional | None | $177.83 | $177.83 | $199.53 |
CareFirst Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $186.21 | Professional | None | $144.54 | $144.54 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $165.96 Typical High $165.96 | Facility | None | $141.25 | $165.96 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $165.96 | Professional | None | $120.23 | $120.23 | $165.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $190.55 Median $269.15 Typical High $354.81 | Professional | None | $190.55 | $269.15 | $354.81 |
Medcost Setting Professional Modifier None Typical Low $158.49 Median $177.83 Typical High $251.19 | Professional | None | $158.49 | $177.83 | $251.19 |
Medcost Setting Facility Modifier None Typical Low $95.50 Median $144.54 Typical High $177.83 | Facility | None | $95.50 | $144.54 | $177.83 |
Medcost Setting Professional Modifier None Typical Low $128.82 Median $165.96 Typical High $177.83 | Professional | None | $128.82 | $165.96 | $177.83 |
Sentara Setting Facility Modifier None Typical Low $131.83 Median $186.21 Typical High $588.84 | Facility | None | $131.83 | $186.21 | $588.84 |
Sentara Setting Professional Modifier None Typical Low $144.54 Median $199.53 Typical High $407.38 | Professional | None | $144.54 | $199.53 | $407.38 |
United Setting Facility Modifier None Typical Low $134.90 Median $141.25 Typical High $363.08 | Facility | None | $134.90 | $141.25 | $363.08 |
United Setting Professional Modifier None Typical Low $123.03 Median $131.83 Typical High $204.17 | Professional | None | $123.03 | $131.83 | $204.17 |
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 $70.79 Median $70.79 Typical High $70.79 | Professional | 52 · Reduced service | $70.79 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | 53 · Discontinued | $28.18 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $20.89 Typical High $21.38 | Professional | 55 · Aftercare only | $20.89 | $20.89 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | 56 · Pre-op care only | $14.13 | $14.13 | $14.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $18.20 Median $18.20 Typical High $21.38 | Professional | RR · Rental | $18.20 | $18.20 | $21.38 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $131.83 Median $134.90 Typical High $141.25 | Professional | UE · Used equipment | $131.83 | $134.90 | $141.25 |
Where Virginia sits
The same service costs 2.8 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· 28th of 51
$178
MT $331DE $120
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.