How much rates vary
Facilitymedian $363 · 10th to 90th $275 to $813Professionalmedian $316 · 10th to 90th $245 to $437
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 $275.42 Median $275.42 Typical High $281.84 | Facility | None | $275.42 | $275.42 | $281.84 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $275.42 Typical High $281.84 | Professional | None | $269.15 | $275.42 | $281.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $562.34 | Facility | None | $537.03 | $537.03 | $562.34 |
Anthem BCBS Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $363.08 | Professional | None | $316.23 | $316.23 | $363.08 |
CareFirst Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $363.08 | Professional | None | $281.84 | $281.84 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $338.84 Typical High $338.84 | Facility | None | $281.84 | $338.84 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $338.84 | Professional | None | $245.47 | $245.47 | $338.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $371.54 Median $537.03 Typical High $691.83 | Professional | None | $371.54 | $537.03 | $691.83 |
Medcost Setting Professional Modifier None Typical Low $316.23 Median $346.74 Typical High $489.78 | Professional | None | $316.23 | $346.74 | $489.78 |
Medcost Setting Facility Modifier None Typical Low $186.21 Median $288.40 Typical High $346.74 | Facility | None | $186.21 | $288.40 | $346.74 |
Medcost Setting Professional Modifier None Typical Low $234.42 Median $295.12 Typical High $346.74 | Professional | None | $234.42 | $295.12 | $346.74 |
Sentara Setting Facility Modifier None Typical Low $263.03 Median $371.54 Typical High $1,148.15 | Facility | None | $263.03 | $371.54 | $1,148.15 |
Sentara Setting Professional Modifier None Typical Low $288.40 Median $389.05 Typical High $812.83 | Professional | None | $288.40 | $389.05 | $812.83 |
United Setting Facility Modifier None Typical Low $263.03 Median $363.08 Typical High $707.95 | Facility | None | $263.03 | $363.08 | $707.95 |
United Setting Professional Modifier None Typical Low $245.47 Median $263.03 Typical High $398.11 | Professional | None | $245.47 | $263.03 | $398.11 |
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 $134.90 Median $138.04 Typical High $138.04 | Professional | 52 · Reduced service | $134.90 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $54.95 Typical High $56.23 | Professional | 53 · Discontinued | $54.95 | $54.95 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $41.69 Typical High $41.69 | Professional | 55 · Aftercare only | $40.74 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $27.54 Typical High $28.18 | Professional | 56 · Pre-op care only | $26.92 | $27.54 | $28.18 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $32.36 Median $32.36 Typical High $40.74 | Professional | RR · Rental | $32.36 | $32.36 | $40.74 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $239.88 Median $245.47 Typical High $257.04 | Professional | UE · Used equipment | $239.88 | $245.47 | $257.04 |
Where Virginia sits
The same service costs 2.8 times more in Wyoming 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· 38th of 51
$316
WY $676DE $245
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.