How much rates vary
Facilitymedian $589 · 10th to 90th $398 to $1,202Professionalmedian $479 · 10th to 90th $398 to $661
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 $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $851.14 | Facility | None | $812.83 | $812.83 | $851.14 |
Anthem BCBS Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $588.84 | Professional | None | $478.63 | $478.63 | $588.84 |
CareFirst Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $549.54 | Professional | None | $426.58 | $426.58 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $588.84 Typical High $588.84 | Facility | None | $380.19 | $588.84 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $588.84 | Professional | None | $426.58 | $426.58 | $588.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $562.34 Median $812.83 Typical High $1,047.13 | Professional | None | $562.34 | $812.83 | $1,047.13 |
Medcost Setting Professional Modifier None Typical Low $478.63 Median $524.81 Typical High $741.31 | Professional | None | $478.63 | $524.81 | $741.31 |
Medcost Setting Facility Modifier None Typical Low $281.84 Median $436.52 Typical High $524.81 | Facility | None | $281.84 | $436.52 | $524.81 |
Medcost Setting Professional Modifier None Typical Low $389.05 Median $446.68 Typical High $524.81 | Professional | None | $389.05 | $446.68 | $524.81 |
Sentara Setting Facility Modifier None Typical Low $389.05 Median $549.54 Typical High $1,737.80 | Facility | None | $389.05 | $549.54 | $1,737.80 |
Sentara Setting Professional Modifier None Typical Low $436.52 Median $588.84 Typical High $1,202.26 | Professional | None | $436.52 | $588.84 | $1,202.26 |
United Setting Facility Modifier None Typical Low $181.97 Median $398.11 Typical High $1,071.52 | Facility | None | $181.97 | $398.11 | $1,071.52 |
United Setting Professional Modifier None Typical Low $363.08 Median $398.11 Typical High $602.56 | Professional | None | $363.08 | $398.11 | $602.56 |
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 $208.93 Median $208.93 Typical High $208.93 | Professional | 52 · Reduced service | $208.93 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $85.11 | Professional | 53 · Discontinued | $83.18 | $83.18 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $41.69 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $47.86 Median $47.86 Typical High $61.66 | Professional | RR · Rental | $47.86 | $47.86 | $61.66 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $363.08 Median $363.08 Typical High $389.05 | Professional | UE · Used equipment | $363.08 | $363.08 | $389.05 |
Where Virginia sits
The same service costs 2.5 times more in Montana than in Alabama. 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· 37th of 51
$479
MT $1,072AL $427
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.